title: A prospective pilot study measuring muscle volumetric change in amyotrophic lateral sclerosis.
abstract: Our objective was to investigate the potential of muscle volume, measured with magnetic resonance (MR), as a biomarker to quantify disease progression in patients with amyotrophic lateral sclerosis (ALS). In this longitudinal pilot study, we first sought to determine the stability of volumetric muscle MR measurements in 11 control subjects at two time-points. We assessed feasibility of detecting atrophy in four patients with ALS, followed at three-month intervals for 12 months. Muscle power and MR volume were measured in thenar eminence (TEm), first dorsal interosseous (1DIO), tibialis anterior (TA) and tongue. Changes over time were assessed using linear regression models and t-tests. Results demonstrated that, in controls, no volumetric MR changes were seen (mean volume variation in all muscles < 5%, p > 0.1). In patients, between-subject heterogeneity was identified. Trends for volume loss were found in TEm (mean, - 26.84%, p = 0.056) and TA (- 8.29%, p = 0.077), but not in 1DIO (- 18.47%, p = 0.121) or tongue (< 5%, p = 0.367). In conclusion, volumetric muscle MR appears a stable measure in controls, and progressive volume loss was demonstrable in individuals with ALS in whom clinical weakness progressed. In this small study, subclinical atrophy was not demonstrable using muscle MR. Clinico-radiological discordance between muscle weakness and MR atrophy could reflect a contribution of upper motor neuron pathology.
authors.affiliation: Sheffield Institute for Translational Neuroscience (SITraN), 385a Glossop Road, Sheffield, UK. Thomas.Jenkins@sth.nhs.uk
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Jenkins
authors.forename: Christine
authors.initials: C
authors.lastname: Burness
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Connolly
authors.forename: D Ganesh
authors.initials: DG
authors.lastname: Rao
authors.forename: Nigel
authors.initials: N
authors.lastname: Hoggard
authors.forename: Susan
authors.initials: S
authors.lastname: Mawson
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: McDermott
authors.forename: Iain D
authors.initials: ID
authors.lastname: Wilkinson
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Shaw
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000473:pathology*; D016022:Case-Control Studies; D018450:Disease Progression; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D053581:Muscle Strength Dynamometer; D018908:Muscle Weakness / Q000209:etiology / Q000473:pathology; D018482:Muscle, Skeletal / Q000473:pathology*; D009133:Muscular Atrophy / Q000209:etiology / Q000473:pathology*; D009929:Organ Size; D010865:Pilot Projects; D011446:Prospective Studies