title: Tractography in amyotrophic lateral sclerosis using a novel probabilistic tool: a study with tract-based reconstruction compared to voxel-based approach.
abstract: BACKGROUND
  Diffusion tensor imaging (DTI) is one of the most sensitive MRI tools for detecting subtle cerebral white matter abnormalities in amyotrophic lateral sclerosis (ALS). Nowadays a plethora of DTI tools have been proposed, but very few methods have been translated into clinical practice.
  
  
  METHODS
  The aim of this study is to validate the objective measurement of fiber tracts as provided by a new unbiased and automated tractography reconstruction tool named as TRActs Constrained by UnderLying Anatomy (TRACULA). The reliability of this tract-based approach was evaluated on a dataset of 14 patients with definite ALS compared with 14 age/sex-matched healthy controls. To further corroborate these measurements, we used a well-known voxelwise approach, called tract-based spatial statistics (TBSS), on the same dataset.
  
  
  RESULTS
  TRACULA showed specific significant alterations of several DTI parameters in the corticospinal tract of the ALS group with respect to controls.
  
  
  CONCLUSIONS
  The same finding was detected using the well-known TBSS analysis. Similarly, both methods depicted also additional microstructural changes in the cingulum.
  
  
  CONCLUSIONS
  DTI tractography metrics provided by TRACULA perfectly agree with those previously reported in several post-mortem and DTI studies, thus demonstrating the accuracy of this method in characterizing the microstructural changes occurring in ALS. With further validation (i.e. considering the heterogeneity of other clinical phenotypes), this method has the potential to become useful for clinical practice providing objective measurements that might aid radiologists in the interpretation of MR images and improve diagnostic accuracy of ALS.
authors.affiliation: Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Sarica
authors.affiliation: IBFM, National Research Council, Germaneto, Catanzaro, Italy; Institute of Neurology, University "Magna Graecia", Germaneto, Catanzaro, Italy. Electronic address: a.cerasa@unicz.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cerasa
authors.affiliation: IBFM, National Research Council, Germaneto, Catanzaro, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Vasta
authors.affiliation: IBFM, National Research Council, Germaneto, Catanzaro, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Perrotta
authors.affiliation: Institute of Neurology, University "Magna Graecia", Germaneto, Catanzaro, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Valentino
authors.affiliation: IBFM, National Research Council, Germaneto, Catanzaro, Italy.
authors.forename: Graziella
authors.initials: G
authors.lastname: Mangone
authors.affiliation: Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy.
authors.forename: Pietro H
authors.initials: PH
authors.lastname: Guzzi
authors.affiliation: IBFM, National Research Council, Germaneto, Catanzaro, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Rocca
authors.affiliation: IBFM, National Research Council, Germaneto, Catanzaro, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Nonnis
authors.affiliation: Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Cannataro
authors.affiliation: IBFM, National Research Council, Germaneto, Catanzaro, Italy; Institute of Neurology, University "Magna Graecia", Germaneto, Catanzaro, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Quattrone
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000473:pathology*; D016880:Anisotropy; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D011712:Pyramidal Tracts / Q000473:pathology*
keywords: Amyotrophic lateral sclerosis; Corticospinal tract; DTI; TRACULA; Tractography