Longitudinal evaluation of cerebral and spinal cord damage in Amyotrophic Lateral Sclerosis

Author(s)

de Albuquerque, Milena ; Branco, Lucas Melo T. ; Rezende, Thiago Junqueira R. ; Tavares de Andrade, Helen Maia ; Nucci, Anamarli ; Franca, Jr., Marcondes Cavalcante

• Document type: Journal article
• Source: NEUROIMAGE-CLINICAL; v. 14, p. 269-276, 2017.
• Web of Science Citations: 18

Abstract

Objective: To evaluate MRI-based parameters as biomarkers of Amyotrophic Lateral Sclerosis (ALS) progression. Methods: Twenty-seven patients and 27 controls performed two clinical and MRI acquisitions 8 months apart. ALSFRS-R scale was used to quantify disease severity at both time points. Multimodal analyses of MRI included cortical thickness measurements (FreeSurfer software), analysis of white matter integrity using diffusion-tensor imaging (tract-based spatial statistics-TBSS) and measurement of cervical spinal cord cross-sectional area (SpineSeg software). All analyses were corrected for multiple comparisons. The standardized response mean (SRM = mean score change / standard deviation of score change) was calculated for all methods herein employed and used for comparison purposes. Results: There were 18 men and mean age at first examination was 51.9 years. Mean ALSFRS-R scores at baseline and follow-upwere 34.0 and 29.0, respectively. There was no region with progressive cortical thinning, but there was significant brainstem volumetric reduction (p = 0.001). TBSS analyses revealed progressive increase of AD ( axial diffusivity) and MD ( mean diffusivity) at the corpus callosum ( p < 0.05), whereas SpineSeg showed progressive cord area reduction ( p = 0.002). Cervical spinal cord cross-sectional area reduction was the only MRI parameter that correlated with ALSFRS-R change (r = 0.309, p = 0.038). SRM for ALSFRS-R was 0.95, for cord area 0.95, for corpus callosum AD 0.62 and MD 0.65, and for brainstem volume 0.002. Conclusions: Structural MRI is able to detect short term longitudinal changes in ALS. Cervical spinal cord morphometry is a promising neuroimaging marker to assess ALS course. (C) 2017 The Authors. Published by Elsevier Inc. (AU)

• FAPESP's process: 11/21521-3 - Study of biomarkers in amyotrophic lateral sclerosis
• Grantee: Milena de Albuquerque
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)