title: Diffusion tensor imaging and voxel based morphometry study in amyotrophic lateral sclerosis: relationships with motor disability.
abstract: The aim of this study was to investigate the extent of cortical and subcortical lesions in amyotrophic lateral sclerosis (ALS) using, in combination, voxel based diffusion tensor imaging (DTI) and voxel based morphometry (VBM). We included 15 patients with definite or probable ALS and 25 healthy volunteers. Patients were assessed using the revised ALS Functional Rating Scale (ALSFRS-R). In patients, reduced fractional anisotropy was found in bilateral corticospinal tracts, the left insula/ventrolateral premotor cortex, the right parietal cortex and the thalamus, which correlated with the ALSFRS-R. Increased mean diffusivity (MD) was found bilaterally in the motor cortex, the ventrolateral premotor cortex/insula, the hippocampal formations and the right superior temporal gyrus, which did not correlate with the ALSFRS-R. VBM analysis showed no changes in white matter but widespread volume decreases in grey matter in several regions exhibiting MD abnormalities. In ALS patients, our results show that subcortical lesions extend beyond the corticospinal tract and are clinically relevant.
authors.affiliation: INSERM U739, Faculté de Médecine Pitié-Salpêtrière, 75013, Paris, France. lionel.thivard@psl.ap-hop-paris.fr
authors.forename: Lionel
authors.initials: L
authors.lastname: Thivard
authors.forename: Pierre-François
authors.initials: PF
authors.lastname: Pradat
authors.forename: Stéphane
authors.initials: S
authors.lastname: Lehéricy
authors.forename: Lucette
authors.initials: L
authors.lastname: Lacomblez
authors.forename: Didier
authors.initials: D
authors.lastname: Dormont
authors.forename: Jacques
authors.initials: J
authors.lastname: Chiras
authors.forename: Habib
authors.initials: H
authors.lastname: Benali
authors.forename: Vincent
authors.initials: V
authors.lastname: Meininger
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000145:classification / Q000150:complications / Q000473:pathology*; D016880:Anisotropy; D000886:Anthropometry; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019957:Motor Skills Disorders / Q000145:classification / Q000209:etiology*