Amyotrophic Lateral Sclerosis (ALS) is a rapidly progressive neurodegenerative disease with no effective treatment and unclear pathophysiology. The diagnosis is difficult, often being delayed by 10 to 12 months after the onset of symptoms and the clinical presentation is variable, also including cognitive and behavioral changes. Thus, the use of reliable biomarkers for early diagnosis and assessment of individual prognosis is important. Special interest has arisen about neuroimaging markers, especially magnetic resonance imaging (MRI) due its ability to assess in vivo changes noninvasively with high anatomical fidelity. Studies using Functional Magnetic Resonance Imaging (fMRI) involving brain activity at rest (resting state) allowed the study of functional motor networks without the need for paradigms, which is especially relevant due to the motor deficits presented by the patients. Functional changes might happen even earlier than anatomical findings, as cortical atrophy, which suggests that fMRI has great potential as a biomarker in early ALS stages. Innovative parameters, such as the amplitude of low frequency fluctuations (ALFF), fractional ALFF(fALFF) and regional homogeneity (ReHo) gained attention recently. These parameters may be related to the degree of cerebral activation. Thus, we propose a longitudinal study to investigate the utility of fMRI , through ALFF, fALFF and ReHo, as clinical and cognitive biomarkers in ALS patients.
News published in Agência FAPESP Newsletter about the scholarship: