| Autor: |
Barbato F; Department of Emergency and Urgent Medicine, Stroke Unit, Santa Maria delle Grazie Hospital, 80078 Naples, Italy., Bombaci A; PhD Program of Neuroscience, Department of Neuroscience 'Rita Levi Montalcini', University of Turin, 10124 Turin, Italy.; Neurology Unit, IRCSS Policlinico San Donato, 20097 San Donato Milanese, Italy.; Department of Neurology, Vita-Salute San Raffaele University, 20132 Milan, Italy., Colacicco G; NeuroMuscular Omnicentre (NEMO), Serena Onlus, 20162 Milan, Italy., Bruno G; Division of Pediatric Neurology, Department of Neurosciences, 'Santobono-Pausilipon' Children's Hospital, 80121 Naples, Italy., Ippolito D; NeuroMuscular Omnicentre (NEMO), Serena Onlus, 20162 Milan, Italy., Pota V; Department of Women, Child, General and Specialistic Surgery, University of Campania 'Luigi Vanvitelli', 81100 Caserta, Italy., Dongiovanni S; NeuroMuscular Omnicentre (NEMO), Serena Onlus, 20162 Milan, Italy., Sica G; Department of Radiology, Monaldi Hospital, Azienda Ospedaliera dei Colli, 80131 Naples, Italy., Bocchini G; Department of Radiology, Monaldi Hospital, Azienda Ospedaliera dei Colli, 80131 Naples, Italy., Valente T; Department of Radiology, Monaldi Hospital, Azienda Ospedaliera dei Colli, 80131 Naples, Italy., Scaglione M; Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy., Mainenti PP; Institute of Biostructures and Bioimaging of the National Council of Research (CNR), 80145 Naples, Italy., Guarino S; Department of Radiology, Monaldi Hospital, Azienda Ospedaliera dei Colli, 80131 Naples, Italy. |
| Abstrakt: |
Background: Amyotrophic lateral sclerosis (ALS) is a neuromuscular progressive disorder characterized by limb and bulbar muscle wasting and weakness. A total of 30% of patients present a bulbar onset, while 70% have a spinal outbreak. Respiratory involvement represents one of the worst prognostic factors, and its early identification is fundamental for the early starting of non-invasive ventilation and for the stratification of patients. Due to the lack of biomarkers of early respiratory impairment, we aimed to evaluate the role of chest dynamic MRI in ALS patients. Methods: We enrolled 15 ALS patients and 11 healthy controls. We assessed the revised ALS functional rating scale, spirometry, and chest dynamic MRI. Data were analyzed by using the Mann-Whitney U test and Cox regression analysis. Results: We observed a statistically significant difference in both respiratory parameters and pulmonary measurements at MRI between ALS patients and healthy controls. Moreover, we found a close relationship between pulmonary measurements at MRI and respiratory parameters, which was statistically significant after multivariate analysis. A sub-group analysis including ALS patients without respiratory symptoms and with normal spirometry values revealed the superiority of chest dynamic MRI measurements in detecting signs of early respiratory impairment. Conclusions: Our data suggest the usefulness of chest dynamic MRI, a fast and economically affordable examination, in the evaluation of early respiratory impairment in ALS patients. |
