title: Progressive and widespread brain damage in ALS: MRI voxel-based morphometry and diffusion tensor imaging study.
abstract: We investigated 17 patients with sporadic amyotrophic lateral sclerosis (ALS) using voxel-based morphometry (VBM) and voxel-based analysis of diffusion tensor images (DTI) at baseline and after a six-month follow-up. Compared with 17 healthy controls, ALS patients at baseline showed only minimal white matter volume decreases in the inferior frontal gyrus but marked decreases in the gray matter of several regions, especially in the bilateral paracentral lobule of the premotor cortex. DTI revealed reduced fractional anisotropy in the bilateral corticospinal tracts, insula, ventrolateral premotor cortex, and parietal cortex. Increased mean diffusivity was noted bilaterally in the motor cortex, ventrolateral premotor cortex, insula, hippocampal formation, and temporal gyrus. At the six-month follow-up, ALS patients showed widespread volume decreases in gray matter, and DTI abnormalities extended mainly into the bilateral frontal lobes, while volume changes in the white matter remained minimal but more distinct. Our combined VBM and DTI techniques revealed extra-corticospinal tract neuronal degeneration mainly in the frontotemporal lobe of ALS patients. In particular, follow-up examinations in these patients showed that whole-brain DTI changes occurred predominantly in the regions of brain atrophy. These objective analyses can be used to assess the disease condition of the ALS brain.
authors.affiliation: Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Joe
authors.initials: J
authors.lastname: Senda
authors.forename: Shigenori
authors.initials: S
authors.lastname: Kato
authors.forename: Tomotsugu
authors.initials: T
authors.lastname: Kaga
authors.forename: Mizuki
authors.initials: M
authors.lastname: Ito
authors.forename: Naoki
authors.initials: N
authors.lastname: Atsuta
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Nakamura
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Watanabe
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Tanaka
authors.forename: Shinji
authors.initials: S
authors.lastname: Naganawa
authors.forename: Gen
authors.initials: G
authors.lastname: Sobue
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000690:Amyotrophic Lateral Sclerosis / Q000473:pathology*; D016880:Anisotropy; D000886:Anthropometry; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D056324:Diffusion Tensor Imaging; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012720:Severity of Illness Index; D013702:Temporal Lobe / Q000473:pathology