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Upper motor neuron involvement in amyotrophic lateral sclerosis evaluated by triple stimulation technique and diffusion tensor MRI.
MedLine Citation:
PMID:  23299622     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The objective of this study was to evaluate the diagnostic value of triple stimulation technique (TST) and diffusion tensor imaging (DTI) tractography as markers of upper motor neuron (UMN) degeneration in amyotrophic lateral sclerosis (ALS). Fourteen ALS patients fulfilling the El Escorial criteria and 30 control subjects participated in the study. TST amplitude and area ratio were used as an estimate of the degree of central motor conduction failure. DTI fractional anisotropy was used as a quantitative measure of the structural integrity of the corticospinal tract and the posterior limb of the internal capsule. Mean TST amplitude and area ratio were lower in patients than controls, while there were no differences in mean fractional anisotropy of the corticospinal tract or the posterior limb of the internal capsule. TST was abnormal in 7/13 patients (sensitivity 54 %) and DTI was abnormal in 3/12 (sensitivity 25 %). Combining TST and DTI disclosed abnormalities in 8/11 patients (sensitivity 73 %). TST confirmed UMN degeneration in one of every 2.25 patient in the diagnostic categories lower than 'probable' ALS. Using results from TST as a criterion for UMN degeneration, four patients in diagnostic categories lower than 'probable' ALS and without clinical signs of UMN degeneration in the cervical region increased in diagnostic category. Our findings indicate that TST has a significant diagnostic value as an early objective marker of UMN degeneration in ALS, while the value of DTI analysis seems limited.
Authors:
Jasna Furtula; Birger Johnsen; Jesper Frandsen; Anders Rodell; Peter Broegger Christensen; Kirsten Pugdahl; Anders Fuglsang-Frederiksen
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-9
Journal Detail:
Title:  Journal of neurology     Volume:  -     ISSN:  1432-1459     ISO Abbreviation:  J. Neurol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Clinical Neurophysiology, Aarhus University Hospital, Noerrebrogade 44, Building 10, Parterre, 8000, Aarhus C, Denmark, furtula@gmail.com.
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