Detection of White Matter Ultrastructural Changes for Amyotrophic Lateral Sclerosis Characterization: A Diagnostic Study from Dti-Derived Data
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Updated: Nov 25, 2025
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Fabiola De Marchi1, Alessandro Stecco2, Zeno Falaschi2
1ALS Center & Department of Neurology, "Maggiore della Carità" Hospital, University of Piemonte Orientale (UPO), Via Solaroli 17, 28100 Novara, Italy.
Abstract:
In amyotrophic lateral sclerosis (ALS), magnetic resonance imaging (MRI) allows investigation at the microstructural level, employing techniques able to reveal white matter changes. In the current study, a diffusion tensor imaging (DTI) analysis, with a collection of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) indexes, was performed in ALS patients to correlate geno- and phenotype features with MRI data, to investigate an in-vivo correlation of different neuropathological patterns. All patients who underwent the MR-DTI analysis were retrospectively recruited. MRI scan was collected within three months from diagnosis. FA and ADC values were collected in corpus callosum (CC), corona radiata (CR), cerebral peduncle (CR), cerebellar peduncle (CbP) and corticospinal tract at posterior limb of internal capsule (CST). DTI analysis performed in the whole ALS cohort revealed significant FA reduction and ADC increase in all selected regions, as widespread changes. Moreover, we observed a higher value of FA in rCR in bulbar patients. A positive correlation between ALS Functional Rating Scale-Revised and FA in rCP was evident. In consideration of the non-invasiveness, the reliability and the easy reproducibility of the method, we believe that brain MRI with DTI analyses may represent a valid tool usable as a diagnostic marker in ALS.
Insights
Diffusion tensor imaging (DTI) reveals widespread white matter changes in amyotrophic lateral sclerosis (ALS) patients. These magnetic resonance imaging (MRI) findings correlate with disease characteristics, suggesting DTI
Area of Science:
- Neuroimaging
- Neurology
- Biomedical Engineering
Background:
- Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting motor neurons.
- Magnetic resonance imaging (MRI) offers microstructural insights into white matter changes in ALS.
- Diffusion tensor imaging (DTI) quantifies water diffusion to assess white matter integrity.
Purpose of the Study:
- To investigate in-vivo correlations between genotype/phenotype features and DTI metrics in ALS patients.
- To identify neuropathological patterns using diffusion tensor imaging (DTI) in amyotrophic lateral sclerosis (ALS).
- To evaluate the potential of DTI as a diagnostic marker for ALS.
Main Methods:
- Retrospective analysis of MR-DTI scans from ALS patients within three months of diagnosis.
- Collection of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values in specific white matter tracts (CC, CR, CP, CbP, CST).
- Correlation of DTI metrics with genotypic and phenotypic features, including ALS Functional Rating Scale-Revised (ALSFRS-R).
Main Results:
- Significant reduction in FA and increase in ADC observed across all analyzed white matter regions in the ALS cohort.
- Higher FA values in the right corona radiata (rCR) were noted in patients with bulbar onset.
- A positive correlation found between ALSFRS-R scores and FA in the right cerebral peduncle (rCP).
Conclusions:
- DTI analysis reveals widespread white matter abnormalities in ALS patients.
- Specific DTI findings correlate with clinical presentation and disease severity.
- Brain MRI with DTI shows promise as a reliable, non-invasive diagnostic tool for ALS.
