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Open Access Highly Accessed Research article

Longitudinal diffusion tensor imaging in amyotrophic lateral sclerosis

Carsten Keil3, Tino Prell1*, Thomas Peschel2, Viktor Hartung1, Reinhard Dengler3 and Julian Grosskreutz1

Author Affiliations

1 Department of Neurology, Jena University Hospital, Erlanger Allee 101, Jena, 07747, Germany

2 Department of Psychiatry and Psychotherapy, Medical School Hannover, Carl-Neuberg-Strasse 1, Hannover, 30625, Germany

3 Department of Neurology and Clinical Neurophysiology, Medical School Hannover, Carl-Neuberg-Str.1, Hannover, 30625, Germany

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BMC Neuroscience 2012, 13:141  doi:10.1186/1471-2202-13-141

Published: 8 November 2012

Abstract

Background

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder, caused by progressive loss of motor neurons. Changes are widespread in the subcortical white matter in ALS. Diffusion tensor imaging (DTI) detects pathological changes in white matter fibres in vivo, based on alterations in the degree (diffusivity, ADC) and directedness (fractional anisotropy, FA) of proton movement.

Methods

24 patients with ALS and 24 age-matched controls received 1.5T DTI. FA and ADC were analyzed using statistical parametric mapping. In 15 of the 24 ALS patients, a second DTI was obtained after 6 months.

Results

Decreased FA in the corticospinal tract (CST) and frontal areas confirm existing results. With a direct comparison of baseline and follow-up dataset, the progression of upper motor neuron degeneration, reflected in FA decrease, could be captured along the CST and in frontal areas. The involvement of cerebellum in the pathology of ALS, as suspected from functional MRI studies, could be confirmed by a reduced FA (culmen, declive). These structural changes correlated well with disease duration, ALSFRS-R, and physical and executive functions.

Conclusion

DTI detects changes that are regarded as prominent features of ALS and thus, shows promise in its function as a biomarker. Using the technique herein, we could demonstrate DTI changes at follow-up which correlated well with clinical progression.

Keywords:
Cerebellum; Amyotrophic lateral sclerosis; Diffusion tensor imaging; Follow-up