title: Multi-parametric spinal cord MRI as potential progression marker in amyotrophic lateral sclerosis.
abstract: OBJECTIVE
  To evaluate multimodal MRI of the spinal cord in predicting disease progression and one-year clinical status in amyotrophic lateral sclerosis (ALS) patients.
  
  
  METHODS
  After a first MRI (MRI1), 29 ALS patients were clinically followed during 12 months; 14/29 patients underwent a second MRI (MRI2) at 11±3 months. Cross-sectional area (CSA) that has been shown to be a marker of lower motor neuron degeneration was measured in cervical and upper thoracic spinal cord from T2-weighted images. Fractional anisotropy (FA), axial/radial/mean diffusivities (λ⊥, λ//, MD) and magnetization transfer ratio (MTR) were measured within the lateral corticospinal tract in the cervical region. Imaging metrics were compared with clinical scales: Revised ALS Functional Rating Scale (ALSFRS-R) and manual muscle testing (MMT) score.
  
  
  RESULTS
  At MRI1, CSA correlated significantly (P<0.05) with MMT and arm ALSFRS-R scores. FA correlated significantly with leg ALFSRS-R scores. One year after MRI1, CSA predicted (P<0.01) arm ALSFSR-R subscore and FA predicted (P<0.01) leg ALSFRS-R subscore. From MRI1 to MRI2, significant changes (P<0.01) were detected for CSA and MTR. CSA rate of change (i.e. atrophy) highly correlated (P<0.01) with arm ALSFRS-R and arm MMT subscores rate of change.
  
  
  CONCLUSIONS
  Atrophy and DTI metrics predicted ALS disease progression. Cord atrophy was a better biomarker of disease progression than diffusion and MTR. Our study suggests that multimodal MRI could provide surrogate markers of ALS that may help monitoring the effect of disease-modifying drugs.
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, UM CR 2, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; INSERM, U 1146, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France.
authors.forename: Mohamed-Mounir
authors.initials: MM
authors.lastname: El Mendili
authors.affiliation: Ecole Polytechnique de Montréal, Département de Génie Électrique, Montréal, Québec, Canada.
authors.forename: Julien
authors.initials: J
authors.lastname: Cohen-Adad
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, UM CR 2, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; INSERM, U 1146, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Pelegrini-Issac
authors.affiliation: Université de Montréal, GRSNC, Faculty de Médecine, Montréal, Québec, Canada.
authors.forename: Serge
authors.initials: S
authors.lastname: Rossignol
authors.affiliation: AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département d'Explorations Fonctionnelles Neurologiques, Paris, Île-de-France, France.
authors.forename: Régine
authors.initials: R
authors.lastname: Morizot-Koutlidis
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, UM CR 2, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; INSERM, U 1146, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Marchand-Pauvert
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, UM CR 2, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; INSERM, U 1146, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Iglesias
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, UM CR 2, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; INSERM, U 1146, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France.
authors.forename: Sina
authors.initials: S
authors.lastname: Sangari
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, UM CR 2, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; INSERM, U 1146, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France.
authors.forename: Rose
authors.initials: R
authors.lastname: Katz
authors.affiliation: Inserm U975, UPMC Univ Paris 6, UMR-S975, CNRS UMR7225, Centre de recherche de l'Institut du Cerveau et de la Moelle épinière - CRICM, Centre de Neuroimagerie de Recherche - CENIR, Paris, Île-de-France, France; APHP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neuroradiologie, Paris, Île-de-France, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Lehericy
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, UM CR 2, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; INSERM, U 1146, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France.
authors.forename: Habib
authors.initials: H
authors.lastname: Benali
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, UM CR 2, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; INSERM, U 1146, Laboratoire d'Imagerie Biomédicale, Paris, Île-de-France, France; APHP, Groupe Hospitalier Pitié-Salpêtrière, Département des Maladies du système Nerveux, Paris, Île-de-France, France.
authors.forename: Pierre-François
authors.initials: PF
authors.lastname: Pradat
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis* / Q000473:pathology*; D003710:Demography; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011712:Pyramidal Tracts / Q000473:pathology; D013116:Spinal Cord / Q000473:pathology*
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