Involvement of cortico-efferent tracts in flail arm syndrome: a tract-of-interest-based DTI study

Autor: Hans-Peter Müller, Kelly Del Tredici, Jan Kassubek, Hans-Jürgen Huppertz, Heiko Braak, Albert C. Ludolph, Angela Rosenbohm
Rok vydání: 2021
Předmět:
medicine.medical_specialty
Neurology
diagnostic imaging [Arm]
Pyramidal Tracts
methods [Diffusion Tensor Imaging]
White matter
Magnetic resonance imaging
Atrophy
diagnostic imaging [Amyotrophic Lateral Sclerosis]
methods [Image Processing
Computer-Assisted]
Fractional anisotropy
medicine
Image Processing
Computer-Assisted
Humans
ddc:610
Motor neuron disease
Vascular Diseases
Amyotrophic lateral sclerosis
pathology [Amyotrophic Lateral Sclerosis]
Flail arm syndrome
Neuroradiology
Brain Mapping
medicine.diagnostic_test
business.industry
Amyotrophic Lateral Sclerosis
pathology [Arm]
Anatomy
medicine.disease
Diffusion tensor imaging
medicine.anatomical_structure
Diffusion Tensor Imaging
complications [Amyotrophic Lateral Sclerosis]
Arm
Disease Progression
Anisotropy
Neurology (clinical)
business
Diffusion MRI
Zdroj: Journal of neurology 269(5), 2619-2626 (2021). doi:10.1007/s00415-021-10854-6
ISSN: 1432-1459
DOI: 10.1007/s00415-021-10854-6
Popis: Background Flail arm syndrome is a restricted phenotype of motor neuron disease that is characterized by progressive, predominantly proximal weakness and atrophy of the upper limbs. Objective The study was designed to investigate specific white matter alterations in diffusion tensor imaging (DTI) data from flail arm syndrome patients using a hypothesis-guided tract-of-interest-based approach to identify in vivo microstructural changes according to a neuropathologically defined amyotrophic lateral sclerosis (ALS)-related pathology of the cortico-efferent tracts. Methods DTI-based white matter mapping was performed both by an unbiased voxel-wise statistical comparison and by a hypothesis-guided tract-wise analysis of fractional anisotropy (FA) maps according to the neuropathological ALS-propagation pattern for 43 flail arm syndrome patients vs 43 ‘classical’ ALS patients vs 40 matched controls. Results The analysis of white matter integrity demonstrated regional FA reductions for the flail arm syndrome group predominantly along the CST. In the tract-specific analysis according to the proposed sequential cerebral pathology pattern of ALS, the flail arm syndrome patients showed significant alterations of the specific tract systems that were identical to ‘classical’ ALS if compared to controls. Conclusions The DTI study including the tract-of-interest-based analysis showed a microstructural involvement pattern in the brains of flail arm syndrome patients, supporting the hypothesis that flail arm syndrome is a phenotypical variant of ALS.
Databáze: OpenAIRE
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