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. Materials and Methods: After a first MRI (MRI 1), 29 ALS patients were clinically followed during 12 months; 14/29 patients underwent a second MRI (MRI2) at 1163 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 MRI 1, 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. Conclusion: 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. © 2014 El Mendili et al.

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M.-M., E. M., J., C.-A., M., P.-I., S., R., R., M.-K., V., M.-P., … P.-F., P. (2014). Multi-parametric spinal cord MRI as potential progression marker in amyotrophic lateral sclerosis. PLoS ONE, 9(4). https://doi.org/10.1371/journal.pone.0095516 LK  - http://sfx.library.uu.nl/utrecht?sid=EMBASE&issn=19326203&id=doi:10.1371%2Fjournal.pone.0095516&atitle=Multi-parametric+spinal+cord+MRI+as+potential+progression+marker+in+amyotrophic+lateral+sclerosis&stitle=PLoS+ONE&title=PLoS+ONE&volume=9&issue=4&spage=&epage=&aulast=El+Mendili&aufirst=Mohamed-Mounir&auinit=M.-M.&aufull=El+Mendili+M.-M.&coden=POLNC&isbn=&pages=-&date=2014&auinit1=M&auinitm=-M

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