title: Voxel-based MRI intensitometry reveals extent of cerebral white matter pathology in amyotrophic lateral sclerosis.
abstract: Amyotrophic lateral sclerosis (ALS) is characterized by progressive loss of upper and lower motor neurons. Advanced MRI techniques such as diffusion tensor imaging have shown great potential in capturing a common white matter pathology. However the sensitivity is variable and diffusion tensor imaging is not yet applicable to the routine clinical environment. Voxel-based morphometry (VBM) has revealed grey matter changes in ALS, but the bias-reducing algorithms inherent to traditional VBM are not optimized for the assessment of the white matter changes. We have developed a novel approach to white matter analysis, namely voxel-based intensitometry (VBI). High resolution T1-weighted MRI was acquired at 1.5 Tesla in 30 ALS patients and 37 age-matched healthy controls. VBI analysis at the group level revealed widespread white matter intensity increases in the corticospinal tracts, corpus callosum, sub-central, frontal and occipital white matter tracts and cerebellum. VBI results correlated with disease severity (ALSFRS-R) and patterns of cerebral involvement differed between bulbar- and limb-onset. VBI would be easily translatable to the routine clinical environment, and once optimized for individual analysis offers significant biomarker potential in ALS.
authors.affiliation: Hans-Berger Department of Neurology, University Hospital Jena, Jena, Germany.
authors.forename: Viktor
authors.initials: V
authors.lastname: Hartung
authors.affiliation: Hans-Berger Department of Neurology, University Hospital Jena, Jena, Germany.
authors.forename: Tino
authors.initials: T
authors.lastname: Prell
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Gaser
authors.affiliation: Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, United Kingdom.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Turner
authors.affiliation: Hans-Berger Department of Neurology, University Hospital Jena, Jena, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Tietz
authors.affiliation: Department of Palliative Medicine, University Medical Centre, Goettingen, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ilse
authors.affiliation: Department of Radiology, Section Neuroradiology, University Hospital Jena, Jena, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Bokemeyer
authors.affiliation: Hans-Berger Department of Neurology, University Hospital Jena, Jena, Germany; Center for Sepsis Control and Care (CSCC), University Hospital Jena, Jena, Germany.
authors.forename: Otto W
authors.initials: OW
authors.lastname: Witte
authors.affiliation: Hans-Berger Department of Neurology, University Hospital Jena, Jena, Germany.
authors.forename: Julian
authors.initials: J
authors.lastname: Grosskreutz
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000473:pathology*; D054022:Cerebrum / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D066127:White Matter / Q000473:pathology*