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<meta name="DC.Title" content="Assessment of White Matter Tract Damage in Patients with Amyotrophic Lateral Sclerosis: A Diffusion Tensor MR Imaging Tractography Study" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2105" />
<meta name="DC.Date" content="2010-09-01" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Most DTI studies in ALS have been limited to the assessment of the CST damage. In this study, we used DTI tractography to investigate whether microstructural abnormalities occur in the major motor and extramotor WM tracts in mildly disabled patients with ALS.

MATERIALS AND METHODS: Brain conventional MR imaging and DTI were performed in 24 patients with probable or definite ALS and mild disability (ALSFRS score, ≥20) and 20 healthy controls. The mean disease progression rate was 0.62 (range = 0.08–2.50). DTI tractography was used to segment the CST, the corpus callosum, and the major WM association tracts (ie, cingulum, uncinate fasciculus, inferior fronto-occipital, inferior longitudinal, and superior longitudinal fasciculi).

RESULTS: Compared with healthy controls, patients with ALS showed significantly decreased FA and significantly increased MD and radial D of the CST bilaterally ( P values from .005 to .01). Patients with ALS also had a significantly increased axial D of the right uncinate fasciculus relative to controls ( P = .04). CST FA significantly correlated with the rate of disease progression (right CST: r = −0.50, P = .02; left CST: r = −0.41, P = .05).

CONCLUSIONS: Patients with ALS and mild disability have preferential damage to the CST. The association of CST damage with the rate of disease progression suggests that DTI has the potential to provide in vivo markers of ALS evolution. The subtle involvement of the uncinate fasciculus may precede the appearance of behavioral symptoms in patients with ALS.

ALS
:   amyotrophic lateral sclerosis
ALSFRS
:   ALS Functional Rating Scale
axial D
:   axial diffusivity
CST
:   corticospinal tract
DE
:   dual-echo
DTI
:   diffusion tensor imaging
FA
:   fractional anisotropy
FTD
:   frontotemporal dementia
MD
:   mean diffusivity
radial D
:   radial diffusivity
WM
:   white matter" />
<meta name="DC.Contributor" content="F. Agosta" />
<meta name="DC.Contributor" content="E. Pagani" />
<meta name="DC.Contributor" content="M. Petrolini" />
<meta name="DC.Contributor" content="D. Caputo" />
<meta name="DC.Contributor" content="M. Perini" />
<meta name="DC.Contributor" content="A. Prelle" />
<meta name="DC.Contributor" content="F. Salvi" />
<meta name="DC.Contributor" content="M. Filippi" />
<meta name="article:published_time" content="2010-09-01" />
<meta name="article:section" content="Brain" />
<meta name="citation_title" content="Assessment of White Matter Tract Damage in Patients with Amyotrophic Lateral Sclerosis: A Diffusion Tensor MR Imaging Tractography Study" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Most DTI studies in ALS have been limited to the assessment of the CST damage. In this study, we used DTI tractography to investigate whether microstructural abnormalities occur in the major motor and extramotor WM tracts in mildly disabled patients with ALS.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Brain conventional MR imaging and DTI were performed in 24 patients with probable or definite ALS and mild disability (ALSFRS score, ≥20) and 20 healthy controls. The mean disease progression rate was 0.62 (range = 0.08–2.50). DTI tractography was used to segment the CST, the corpus callosum, and the major WM association tracts (ie, cingulum, uncinate fasciculus, inferior fronto-occipital, inferior longitudinal, and superior longitudinal fasciculi).&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Compared with healthy controls, patients with ALS showed significantly decreased FA and significantly increased MD and radial D of the CST bilaterally (&lt;i&gt;P&lt;/i&gt; values from .005 to .01). Patients with ALS also had a significantly increased axial D of the right uncinate fasciculus relative to controls (&lt;i&gt;P&lt;/i&gt; = .04). CST FA significantly correlated with the rate of disease progression (right CST: &lt;i&gt;r&lt;/i&gt; = −0.50, &lt;i&gt;P&lt;/i&gt; = .02; left CST: &lt;i&gt;r&lt;/i&gt; = −0.41, &lt;i&gt;P&lt;/i&gt; = .05).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Patients with ALS and mild disability have preferential damage to the CST. The association of CST damage with the rate of disease progression suggests that DTI has the potential to provide in vivo markers of ALS evolution. The subtle involvement of the uncinate fasciculus may precede the appearance of behavioral symptoms in patients with ALS.&lt;/p&gt;" />
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<meta name="twitter:title" content="Assessment of White Matter Tract Damage in Patients with Amyotrophic Lateral Sclerosis: A Diffusion Tensor MR Imaging Tractography Study" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Most DTI studies in ALS have been limited to the assessment of the CST damage. In this study, we used DTI tractography to investigate whether microstructural abnormalities occur in the major motor and extramotor WM tracts in mildly disabled patients with ALS.

MATERIALS AND METHODS: Brain conventional MR imaging and DTI were performed in 24 patients with probable or definite ALS and mild disability (ALSFRS score, ≥20) and 20 healthy controls. The mean disease progression rate was 0.62 (range = 0.08–2.50). DTI tractography was used to segment the CST, the corpus callosum, and the major WM association tracts (ie, cingulum, uncinate fasciculus, inferior fronto-occipital, inferior longitudinal, and superior longitudinal fasciculi).

RESULTS: Compared with healthy controls, patients with ALS showed significantly decreased FA and significantly increased MD and radial D of the CST bilaterally ( P values from .005 to .01). Patients with ALS also had a significantly increased axial D of the right uncinate fasciculus relative to controls ( P = .04). CST FA significantly correlated with the rate of disease progression (right CST: r = −0.50, P = .02; left CST: r = −0.41, P = .05).

CONCLUSIONS: Patients with ALS and mild disability have preferential damage to the CST. The association of CST damage with the rate of disease progression suggests that DTI has the potential to provide in vivo markers of ALS evolution. The subtle involvement of the uncinate fasciculus may precede the appearance of behavioral symptoms in patients with ALS.

ALS
:   amyotrophic lateral sclerosis
ALSFRS
:   ALS Functional Rating Scale
axial D
:   axial diffusivity
CST
:   corticospinal tract
DE
:   dual-echo
DTI
:   diffusion tensor imaging
FA
:   fractional anisotropy
FTD
:   frontotemporal dementia
MD
:   mean diffusivity
radial D
:   radial diffusivity
WM
:   white matter" />
<meta name="og-title" property="og:title" content="Assessment of White Matter Tract Damage in Patients with Amyotrophic Lateral Sclerosis: A Diffusion Tensor MR Imaging Tractography Study" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/31/8/1457" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Most DTI studies in ALS have been limited to the assessment of the CST damage. In this study, we used DTI tractography to investigate whether microstructural abnormalities occur in the major motor and extramotor WM tracts in mildly disabled patients with ALS.

MATERIALS AND METHODS: Brain conventional MR imaging and DTI were performed in 24 patients with probable or definite ALS and mild disability (ALSFRS score, ≥20) and 20 healthy controls. The mean disease progression rate was 0.62 (range = 0.08–2.50). DTI tractography was used to segment the CST, the corpus callosum, and the major WM association tracts (ie, cingulum, uncinate fasciculus, inferior fronto-occipital, inferior longitudinal, and superior longitudinal fasciculi).

RESULTS: Compared with healthy controls, patients with ALS showed significantly decreased FA and significantly increased MD and radial D of the CST bilaterally ( P values from .005 to .01). Patients with ALS also had a significantly increased axial D of the right uncinate fasciculus relative to controls ( P = .04). CST FA significantly correlated with the rate of disease progression (right CST: r = −0.50, P = .02; left CST: r = −0.41, P = .05).

CONCLUSIONS: Patients with ALS and mild disability have preferential damage to the CST. The association of CST damage with the rate of disease progression suggests that DTI has the potential to provide in vivo markers of ALS evolution. The subtle involvement of the uncinate fasciculus may precede the appearance of behavioral symptoms in patients with ALS.

ALS
:   amyotrophic lateral sclerosis
ALSFRS
:   ALS Functional Rating Scale
axial D
:   axial diffusivity
CST
:   corticospinal tract
DE
:   dual-echo
DTI
:   diffusion tensor imaging
FA
:   fractional anisotropy
FTD
:   frontotemporal dementia
MD
:   mean diffusivity
radial D
:   radial diffusivity
WM
:   white matter" />
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">F. Agosta</span>, <span class="highwire-citation-author" data-delta="1">E. Pagani</span>, <span class="highwire-citation-author" data-delta="2">M. Petrolini</span>, <span class="highwire-citation-author" data-delta="3">D. Caputo</span>, <span class="highwire-citation-author" data-delta="4">M. Perini</span>, <span class="highwire-citation-author" data-delta="5">A. Prelle</span>, <span class="highwire-citation-author" data-delta="6">F. Salvi</span> and <span class="highwire-citation-author" data-delta="7">M. Filippi</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">September 2010,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1457-1461; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2105 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-9790--61974893223" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">F. Agosta </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.%2BAgosta%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Agosta%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AF.%2BAgosta%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">E. 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<p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> Most DTI studies in ALS have been limited to the assessment of the CST damage. In this study, we used DTI tractography to investigate whether microstructural abnormalities occur in the major motor and extramotor WM tracts in mildly disabled patients with ALS.</p>
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<p id="p-2"><strong>MATERIALS AND METHODS:</strong> Brain conventional MR imaging and DTI were performed in 24 patients with probable or definite ALS and mild disability (ALSFRS score, ≥20) and 20 healthy controls. The mean disease progression rate was 0.62 (range = 0.08–2.50). DTI tractography was used to segment the CST, the corpus callosum, and the major WM association tracts (ie, cingulum, uncinate fasciculus, inferior fronto-occipital, inferior longitudinal, and superior longitudinal fasciculi).</p>
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<p id="p-3"><strong>RESULTS:</strong> Compared with healthy controls, patients with ALS showed significantly decreased FA and significantly increased MD and radial D of the CST bilaterally (<em>P</em> values from .005 to .01). Patients with ALS also had a significantly increased axial D of the right uncinate fasciculus relative to controls (<em>P</em> = .04). CST FA significantly correlated with the rate of disease progression (right CST: <em>r</em> = −0.50, <em>P</em> = .02; left CST: <em>r</em> = −0.41, <em>P</em> = .05).</p>
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<p id="p-4"><strong>CONCLUSIONS:</strong> Patients with ALS and mild disability have preferential damage to the CST. The association of CST damage with the rate of disease progression suggests that DTI has the potential to provide in vivo markers of ALS evolution. The subtle involvement of the uncinate fasciculus may precede the appearance of behavioral symptoms in patients with ALS.</p>
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</div><div class="section glossary" id="glossary-1"><h2>Abbreviations</h2><dl id="def-list-1"><dt id="def-item-1">ALS<span class="def-item-dt-sep"></span></dt><dd>amyotrophic lateral sclerosis<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">ALSFRS<span class="def-item-dt-sep"></span></dt><dd>ALS Functional Rating Scale<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">axial D<span class="def-item-dt-sep"></span></dt><dd>axial diffusivity<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">CST<span class="def-item-dt-sep"></span></dt><dd>corticospinal tract<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">DE<span class="def-item-dt-sep"></span></dt><dd>dual-echo<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">DTI<span class="def-item-dt-sep"></span></dt><dd>diffusion tensor imaging<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">FA<span class="def-item-dt-sep"></span></dt><dd>fractional anisotropy<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">FTD<span class="def-item-dt-sep"></span></dt><dd>frontotemporal dementia<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">MD<span class="def-item-dt-sep"></span></dt><dd>mean diffusivity<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">radial D<span class="def-item-dt-sep"></span></dt><dd>radial diffusivity<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">WM<span class="def-item-dt-sep"></span></dt><dd>white matter</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">Copyright © American Society of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/31/8/1457.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-title">Assessment of White Matter Tract Damage in Patients with Amyotrophic Lateral Sclerosis: A Diffusion Tensor MR Imaging Tractography Study</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Sep 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1457-1461; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2105 </span></div>
  
  
  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Sep 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1457-1461; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2105 </span></div>
  
  
  
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