Cortical Thinning Pattern of Bulbar- and Spinal-onset Amyotrophic Lateral Sclerosis: a Surface-based Morphometry...

Area of Science:

• Neuroscience
• Neurology
• Radiology

Background:

• Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease.
• Cortical thinning patterns vary between bulbar-onset and spinal-onset ALS subtypes.
• Understanding these patterns is crucial for disease characterization and management.

Purpose of the Study:

• To investigate and compare the cortical thickness alterations in bulbar-onset and spinal-onset ALS patients.
• To explore the correlation between cortical thickness in affected regions and clinical variables.

Main Methods:

• Surface-based morphometry was used to analyze cortical thickness from MRI scans of 65 ALS patients and 65 controls.
• Patients were categorized into bulbar-onset (n=15) and spinal-onset (n=50) subtypes.
• Correlation analyses were performed between cortical thickness and clinical data (disease duration, ALSFRS-R).

Main Results:

• Overall ALS patients exhibited thinning in the precentral and postcentral gyri, and gyrus rectus.
• Bulbar-onset ALS showed thinning in the motor cortex (left precentral gyrus, right supplementary motor cortex).
• Spinal-onset ALS displayed thinning in both motor and extra-motor cortices (left posterior insula, right gyrus rectus).
• Cortical thickness in specific regions correlated with disease duration and functional scores (ALSFRS-R).

Conclusions:

• Distinct cortical thinning patterns characterize bulbar-onset and spinal-onset ALS.
• Motor cortex thinning may reflect intrinsic pathology related to disability.
• Extra-motor cortex thinning in spinal-onset ALS might be a secondary change associated with disease duration.