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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
The Lateral Corticospinal Tract Sign: An MRI Marker for Amyotrophic Lateral Sclerosis
Maria Janina Wendebourg1, Eva Kesenheimer1, Laura Sander1
1From the Translational Imaging in Neurology (ThINk), Department of Biomedical Engineering (M.J.W., E.K., L.S., M. Weigel, C.G., R.S.), Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (M.J.W., E.K., L.S., M. Weigel, C.G., R.S.), Department of Biomedical Engineering (M. Weigel, C.W., O.B.), Institute of Forensic Medicine, Department of Biomedical Engineering (D.N., E.S., C.L.), and Department of Biomedicine (M.S.), University of Basel, Basel, Switzerland; Neurology Clinic and Policlinic, Department of Clinical Research (E.K., L.S., M. Weigel, M.D., N.N., C.G., K.S., M.S., R.S.), Division of Radiological Physics, Department of Radiology (M. Weigel, C.W., T.H., P.M., O.B.), Department of Pathology, Institute of Medical Genetics and Pathology (N.D.), and Department of Theragnostics, Clinic of Radiology and Nuclear Medicine, Division of Diagnostic and Interventional Neuroradiology (J.L.), and Department of Neurology (R.S.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; Institute of Neuropathology, Neurocenter, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany (M.D.); Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland (D.N., E.S., C.L.); and Neuromuscular Diseases Unit/ALS Clinic, Kantonsspital St Gallen, St Gallen, Switzerland (C.N., N.B., M. Weber).
Radially sampled averaged magnetization inversion-recovery acquisition (rAMIRA) MRI shows a hyperintensity sign in the lateral corticospinal tract (CST) that accurately detects amyotrophic lateral sclerosis (ALS). This imaging marker demonstrates high sensitivity and specificity for identifying upper motor neuron degeneration in ALS patients.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Radially sampled averaged magnetization inversion-recovery acquisition (rAMIRA) imaging reveals hyperintensity in the lateral corticospinal tract (CST) in patients with motor neuron diseases.
- This finding suggests a potential imaging biomarker for neurodegenerative conditions affecting the CST.
Purpose of the Study:
- To systematically evaluate the diagnostic accuracy of the lateral CST sign using rAMIRA MRI for detecting amyotrophic lateral sclerosis (ALS).
Main Methods:
- Prospective data from ALS and other motor neuron disease studies were analyzed.
- Participants underwent 3-T axial 2D rAMIRA imaging at four cervical levels.
- The lateral CST sign was defined as spinal cord white matter hyperintensity dorsolateral to anterior horns, exceeding dorsal column signal intensity.
- Accuracy was assessed in a study dataset and an independent validation dataset.
- Postmortem imaging and histopathology were performed on one participant.
Main Results:
- The study included patients with ALS, post-polio syndrome, spinal muscular atrophy, and healthy controls.
- In the study dataset, rAMIRA showed 60% sensitivity and 97% specificity for ALS.
- In the validation dataset, sensitivity was 100% and specificity was 93%.
- Histopathology confirmed axonal loss corresponding to rAMIRA hyperintensities.
Conclusions:
- The lateral CST sign identified by rAMIRA MRI is a promising marker for detecting upper motor neuron degeneration in ALS.
- This imaging technique may aid in the diagnosis and assessment of ALS.
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