Diffusion tensor tractography-based analysis of the pyramidal tract in patients with amyotrophic lateral sclerosis.
OBJECTIVE
We attempted to measure DTI parameters of the brainstem pyramidal tract using two approaches, ie, simple ROI and tract-specific analyses. Results obtained for healthy subjects and ALS patients were compared.


METHODS
DTI was performed using a single shot SE-EPI with 25 noncollinear diffusion gradient directions (b= 1000 second/mm(2)) and with no diffusion gradient on a 3.0-T MR system in 10 ALS patients and in 8 age- and sex-matched normal controls. To delineate the brainstem pyramidal tract, tractography was performed using two ROIs, ie, a seed ROI at the cerebral peduncle (ROI-1) and a target ROI at the lower pons (ROI-2). ROI-1 was subsequently restricted to voxels that contained streamlines in the tract reconstruction, thus creating a sub-ROI.


RESULTS
Mean fractional anisotropy (FA) and mean diffusivity values were highly reproducible by tract specific analysis, whereas simple ROI analysis yielded larger variabilities between operators. FA values were significantly lower in ALS patients than in normal controls in the tractography-derived sub-ROI (P= .01), but not in the seed or target ROIs.


CONCLUSIONS
These results suggest, compared with simple ROI analysis, that tract-specific analysis using DTI fiber-tracking is more reliable and sensitive for detecting upper motor neuron pathology in ALS.
Hong
Yoon-Ho
YH
Department of Neurology, Seoul National University Boramae Hospital, Seoul, South Korea.
Sung
Jung-Joon
JJ
Kim
Sung-Min
SM
Park
Kyung-Seok
KS
Lee
Kwang-Woo
KW
Chang
Kee-Hyun
KH
Song
In Chan
IC
D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000473:pathology*; D000704:Analysis of Variance; D016880:Anisotropy; D016022:Case-Control Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011712:Pyramidal Tracts / Q000473:pathology*