title: Extent of cortical involvement in amyotrophic lateral sclerosis--an analysis based on cortical thickness.
abstract: BACKGROUND
  Besides the defining involvement of upper and lower motor neurons, the involvement of extramotor structures has been increasingly acknowledged in amyotrophic lateral sclerosis (ALS).
  
  
  METHODS
  Here we investigated a group of 14 mildly to moderately affected ALS patients and 14 age-matched healthy control participants using cortical thickness analysis. Cortical thickness was determined from high resolution 3D T1 magnetic resonance images and involved semiautomatic segmentation in grey and white matter, cortical alignment and determination of thickness using the Laplace method. In addition to a whole-cortex analysis a region of interest approach was applied.
  
  
  RESULTS
  ALS patients showed regions of significant cortical thinning in the pre- and postcentral gyri bilaterally. Further regions of cortical thinning included superior and inferior parietal lobule, angular and supramarginal gyrus, insula, superior frontal, temporal and occipital regions, thus further substantiating extramotor involvement in ALS. A relationship between cortical thickness of the right superior frontal cortex and clinical severity (assessed by the ALS functional rating scale) was also demonstrated.
  
  
  CONCLUSIONS
  Cortical thickness is reduced in ALS not only in motor areas but in widespread non-motor cortical areas. Cortical thickness is related to clinical severity.
authors.forename: Johannes
authors.initials: J
authors.lastname: Thorns
authors.forename: Henk
authors.initials: H
authors.lastname: Jansma
authors.forename: Thomas
authors.initials: T
authors.lastname: Peschel
authors.forename: Julian
authors.initials: J
authors.lastname: Grosskreutz
authors.forename: Bahram
authors.initials: B
authors.lastname: Mohammadi
authors.forename: Reinhard
authors.initials: R
authors.lastname: Dengler
authors.affiliation: Department of Neurology, University of Lübeck, Ratzeburger Allee 160, Lübeck, 23538, Germany. Thomas.muente@neuro.uni-luebeck.de.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Münte
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009929:Organ Size