Combined structural and neurochemical evaluation of the corticospinal tract in amyotrophic lateral sclerosis
Timothy Pyraa b, Benjamin Huic, Chris C. Hanstockd, Luis Conchad, John C.T. Wonge, Christian Beaulieud, Wendy S. W. Johnstonf, Sanjay Kalrad f✉
- aDepartment of Medicine, The University of Alberta, Canada
- bThe Faculty of Medicine and Dentistry
- cThe Division of Neurology, Department of Medicine, University of Toronto
- dDepartment of Biomedical Engineering, The University of Alberta
- eThe Department of Medicine, University of British Columbia
- fDivision of Neurology, Department of Medicine
- ✉Corresponding author
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Abstract
Our objective was to characterize the structural and metabolic changes of the corticospinal tract (CST) in ALS patients using combined diffusion tensor imaging (DTI) and magnetic resonance spectroscopic imaging (MRSI). Fourteen patients (male:female, 6:8; mean age, 54 years) and 14 controls (male:female, 8:6; mean age, 53 years) underwent imaging. Four regions of the CST were evaluated: precentral gyrus, corona radiata, posterior limb of the internal capsule, and cerebral peduncle. DTI and MRSI indices tested included fractional anisotropy (FA), apparent diffusion coefficient (ADC), and the ratio of N-acetylaspartate to choline (NAA/Cho) and creatine (NAA/Cr). In the precentral gyrus, NAA/Cho was reduced 18% (p<0.001), NAA/Cr was reduced 9% (p=0.01), and FA was reduced 3% (p=0.02). NAA/Cho and NAA/Cr were reduced in the corona radiata (p<0.001). Reduced NAA/Cho in the precentral gyrus correlated with shorter symptom duration (r=0.66, p=0.02) and faster disease progression (r=-0.65, p=0.008). Increased spasticity correlated with higher ADC in the precentral gyrus (R=0.52, p=0.005). In conclusion, both MRSI and DTI provided in vivo evidence of intracranial degeneration of the CST in ALS that was most prominent rostrally in the precentral gyrus.
TL;DRBoth MRSI and DTI provided in vivo evidence of intracranial degeneration of the CST in ALS that was most prominent rostrally in the precentral gyrus. (Semantic Scholar)