Linear Associations between Clinically Assessed Upper Motor Neuron Disease and Diffusion Tensor Imaging Metrics in Amyotrophic Lateral SclerosisReportar como inadecuado




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Objective

To assess the relationship between clinically assessed Upper Motor Neuron UMN disease in Amyotrophic Lateral Sclerosis ALS and local diffusion alterations measured in the brain corticospinal tract CST by a tractography-driven template-space region-of-interest ROI analysis of Diffusion Tensor Imaging DTI.

Methods

This cross-sectional study included 34 patients with ALS, on whom DTI was performed. Clinical measures were separately obtained including the Penn UMN Score, a summary metric based upon standard clinical methods. After normalizing all DTI data to a population-specific template, tractography was performed to determine a region-of-interest ROI outlining the CST, in which average Mean Diffusivity MD and Fractional Anisotropy FA were estimated. Linear regression analyses were used to investigate associations of DTI metrics MD, FA with clinical measures Penn UMN Score, ALSFRS-R, duration-of-disease, along with age, sex, handedness, and El Escorial category as covariates.

Results

For MD, the regression model was significant p = 0.02, and the only significant predictors were the Penn UMN Score p = 0.005 and age p = 0.03. The FA regression model was also significant p = 0.02; the only significant predictor was the Penn UMN Score p = 0.003.

Conclusions

Measured by the template-space ROI method, both MD and FA were linearly associated with the Penn UMN Score, supporting the hypothesis that DTI alterations reflect UMN pathology as assessed by the clinical examination.



Autor: John H. Woo , Sumei Wang, Elias R. Melhem, James C. Gee, Andrew Cucchiara, Leo McCluskey, Lauren Elman

Fuente: http://plos.srce.hr/



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