Analysis of brain and spinal MRI measures in a common domain to investigate directional neurodegeneration in motor neuron disease.

Autor: Toh C; Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK., Keslake A; Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK., Payne T; Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK., Onwuegbuzie A; Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK., Harding J; Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK., Baster K; School of Mathematics and Statistics, University of Sheffield, Sheffield, UK., Hoggard N; Academic Unit of Radiology, University of Sheffield, Sheffield, UK.; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK., Shaw PJ; Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK.; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK., Wilkinson ID; Academic Unit of Radiology, University of Sheffield, Sheffield, UK., Jenkins TM; Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK. t.m.jenkins@sheffield.ac.uk.; Royal Perth Hospital, Victoria Square, Perth, WA, 6000, Australia. t.m.jenkins@sheffield.ac.uk.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2023 Mar; Vol. 270 (3), pp. 1682-1690. Date of Electronic Publication: 2022 Dec 12.
DOI: 10.1007/s00415-022-11520-1
Abstrakt: Background: Magnetic resonance imaging (MRI) of the brain and cervical spinal cord is often performed in diagnostic evaluation of suspected motor neuron disease/amyotrophic lateral sclerosis (MND/ALS). Analysis of MRI-derived tissue damage metrics in a common domain facilitates group-level inferences on pathophysiology. This approach was applied to address competing hypotheses of directionality of neurodegeneration, whether anterograde, cranio-caudal dying-forward from precentral gyrus or retrograde, dying-back.
Methods: In this cross-sectional study, MRI was performed on 75 MND patients and 13 healthy controls. Precentral gyral thickness was estimated from volumetric T1-weighted images using FreeSurfer, corticospinal tract fractional anisotropy (FA) from diffusion tensor imaging using FSL, and cross-sectional cervical cord area between C1-C8 levels using Spinal Cord Toolbox. To analyse these multimodal data within a common domain, individual parameter estimates representing tissue damage at each corticospinal tract level were first converted to z-scores, referenced to healthy control norms. Mixed-effects linear regression models were then fitted to these z-scores, with gradients hypothesised to represent directionality of neurodegeneration.
Results: At group-level, z-scores did not differ significantly between precentral gyral and intracranial corticospinal tract tissue damage estimates (regression coefficient - 0.24, [95% CI - 0.62, 0.14], p = 0.222), but step-changes were evident between intracranial corticospinal tract and C1 (1.14, [95% CI 0.74, 1.53], p < 0.001), and between C5 and C6 cord levels (0.98, [95% CI 0.58, 1.38], p < 0.001).
Discussion: Analysis of brain and cervical spinal MRI data in a common domain enabled investigation of pathophysiological hypotheses in vivo. A cranio-caudal step-change in MND patients was observed, and requires further investigation in larger cohorts.
(© 2022. The Author(s).)
Databáze: MEDLINE
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