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MRI predictors of long-term evolution in amyotrophic lateral sclerosis.
MedLine Citation:
PMID:  21044177     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
We investigated whether conventional and diffusion tensor (DT) magnetic resonance imaging (MRI) features of the corticospinal tract (CST) contribute to the prediction of the long-term clinical evolution in patients with amyotrophic lateral sclerosis (ALS). Brain conventional and DT MRI were obtained from 18 healthy subjects and 24 patients with sporadic ALS. Mean diffusivity (MD) and fractional anisotropy (FA) of the CST were obtained. Patients were scanned at baseline, then entered a longitudinal clinical follow-up. The ALS Functional Rating scale (ALSFRS) progression rate during follow-up was estimated. Patients were followed up prospectively for a median period of 3.4 years. Two patients were lost at follow-up and eight died during the observation period. The mean ALSFRS progression rate was 0.7/month (range = 0.0–2.0/month). At baseline, ALS patients showed significantly increased MD and decreased FA of the CST compared with controls. CST FA was associated with ALSFRS progression rate. ALSFRS deterioration rate and CST FA were independent predictors of survival in ALS patients. Survival at year 3 was 42% in patients with CST FA ≤ 0.56 compared with 90% in patients with CST FA > 0.56. This study shows that more severe CST DT MRI abnormalities predict a poorer long-term clinical outcome in ALS patients. DT MRI of the brain has the potential to offer in vivo markers of disease severity.
Authors:
Federica Agosta; Elisabetta Pagani; Melissa Petrolini; Maria P Sormani; Domenico Caputo; Michele Perini; Alessandro Prelle; Fabrizio Salvi; Massimo Filippi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The European journal of neuroscience     Volume:  32     ISSN:  1460-9568     ISO Abbreviation:  Eur. J. Neurosci.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8918110     Medline TA:  Eur J Neurosci     Country:  France    
Other Details:
Languages:  eng     Pagination:  1490-6     Citation Subset:  IM    
Affiliation:
Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Scientific Institute and University Ospedale San Raffaele, Via Olgettina 60, 20132 Milan, Italy.
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