title: Longitudinal diffusion tensor imaging in amyotrophic lateral sclerosis.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurology, Jena University Hospital, Erlanger Allee 101, Jena 07747, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Keil
authors.forename: Tino
authors.initials: T
authors.lastname: Prell
authors.forename: Thomas
authors.initials: T
authors.lastname: Peschel
authors.forename: Viktor
authors.initials: V
authors.lastname: Hartung
authors.forename: Reinhard
authors.initials: R
authors.lastname: Dengler
authors.forename: Julian
authors.initials: J
authors.lastname: Grosskreutz
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000473:pathology* / Q000503:physiopathology*; D000704:Analysis of Variance; D001931:Brain Mapping; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D011712:Pyramidal Tracts / Q000473:pathology*; D012720:Severity of Illness Index; D013223:Statistics as Topic