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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
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Brainstem Involvement in Amyotrophic Lateral Sclerosis: A Combined Structural and Diffusion Tensor MRI Analysis.

Haining Li1, Qiuli Zhang1, Qianqian Duan1

  • 1Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Frontiers in Neuroscience
|June 21, 2021
PubMed
Summary

Amyotrophic lateral sclerosis (ALS) patients show brainstem structural changes, including shape abnormalities and white matter integrity loss in key motor tracts. These brainstem alterations correlate with disease severity, offering insights into ALS pathology.

Keywords:
amyotrophic lateral sclerosisbrainstemdiffusion tensor imagingmagnetic resonance imagingshape analysis

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Area of Science:

  • Neuroimaging
  • Neurology
  • Biomedical Engineering

Background:

  • Amyotrophic lateral sclerosis (ALS) involves the brainstem, yet structural brainstem alterations remain understudied.
  • Previous neuroimaging studies in ALS have identified various structural changes, but focused investigation on the brainstem is limited.

Purpose of the Study:

  • To compare brainstem structure between individuals with ALS and healthy controls.
  • To investigate morphological and white matter integrity differences in the brainstem using advanced MRI techniques.

Main Methods:

  • Recruited 33 ALS patients and 33 healthy controls for T1-weighted and diffusion tensor imaging (DTI) on a 3T MRI scanner.
  • Employed volumetric, vertex-wised, and atlas-based region of interest (ROI) analyses to assess brainstem morphology and white matter integrity.
  • Conducted correlation analysis between ALS clinical characteristics and observed structural features.

Main Results:

  • No significant differences in brainstem subregion volumes were found between groups.
  • ALS patients exhibited abnormal surface contractions in the ventral medulla oblongata and ventral pons.
  • Significantly reduced fractional anisotropy (FA) and increased radial diffusivity (RD) were observed in the corticospinal tract (CST) and frontopontine tracts (FPT) in ALS patients.
  • Disease severity positively correlated with FA in the left CST and left FPT.

Conclusions:

  • Brainstem atrophy and degenerative processes are present in ALS patients.
  • Brainstem structural changes, particularly in motor pathways, may reflect and correlate with ALS disease severity.
  • These findings enhance understanding of the neural mechanisms underlying ALS progression.