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<meta name="DC.Title" content="A Distinct MR Imaging Phenotype in Amyotrophic Lateral Sclerosis: Correlation between T1 Magnetization Transfer Contrast Hyperintensity along the Corticospinal Tract and Diffusion Tensor Imaging Analysis" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2855" />
<meta name="DC.Date" content="2012-04-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2012 by American Journal of Neuroradiology. 
Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: In the search for a diagnostic marker in ALS, we focused our attention on the hyperintense signal intensity in T1 MTC MR images along the CST, detected in some patients and not found in other patients with ALS and in control subjects. The aim of this study was to investigate the relationship between the hyperintense signal intensity in T1 MTC images and white matter damage. To this purpose, we studied potential heterogeneities in DTI values within our patients by using TBSS without a priori anatomic information.

MATERIALS AND METHODS: In 43 patients with ALS and 43 healthy control subjects, the presence or absence of T1 MTC hyperintense signal intensity was evaluated. With a DTI analysis with a TBSS approach, differences in FA distribution between the 2 groups (patients with T1 MTC hyperintense signal intensity and patients without it) compared with each other and with control subjects were investigated.

RESULTS: We found regional differences in white matter FA between patients with T1 MTC hyperintense signal intensity (37.2%) and patients without it. Patients with T1 MTC abnormal signal intensity showed lower FA strictly limited to the motor network and the posterior aspect of the body of the CC without extramotor FA reductions, whereas patients without this sign showed FA reductions in several confluent regions within and outside the CST and in the whole CC.

CONCLUSIONS: T1 MTC hyperintense signal intensity in the CST and posterior CC, when present, is specific for ALS and represents, among patients with ALS, a possible distinct phenotype of presentation of the disease with prominent UMN involvement.

ALS
:   amyotrophic lateral sclerosis
CC
:   corpus callosum
CST
:   corticospinal tract
FA
:   fractional anisotropy
FMRIB
:   Functional MR Imaging of the Brain
FSL
:   FMRIB Software Library
LMN
:   lower motor neuron
MNI
:   Montreal Neurological Institute
MT
:   magnetization transfer
MTC
:   magnetization transfer contrast
MTR
:   magnetization transfer ratio
PD
:   proton attenuation
PLS
:   primary lateral sclerosis
SE
:   spin-echo
TBSS
:   tract-based spatial statistics
UMN
:   upper motor neuron" />
<meta name="DC.Contributor" content="G. Carrara" />
<meta name="DC.Contributor" content="C. Carapelli" />
<meta name="DC.Contributor" content="F. Venturi" />
<meta name="DC.Contributor" content="M.M. Ferraris" />
<meta name="DC.Contributor" content="L. Lequio" />
<meta name="DC.Contributor" content="A. Chiò" />
<meta name="DC.Contributor" content="A. Calvo" />
<meta name="DC.Contributor" content="S. Sirgiovanni" />
<meta name="DC.Contributor" content="A. Cistaro" />
<meta name="DC.Contributor" content="M.C. Valentini" />
<meta name="article:published_time" content="2012-04-01" />
<meta name="article:section" content="Brain" />
<meta name="citation_title" content="A Distinct MR Imaging Phenotype in Amyotrophic Lateral Sclerosis: Correlation between T1 Magnetization Transfer Contrast Hyperintensity along the Corticospinal Tract and Diffusion Tensor Imaging Analysis" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;In the search for a diagnostic marker in ALS, we focused our attention on the hyperintense signal intensity in T1 MTC MR images along the CST, detected in some patients and not found in other patients with ALS and in control subjects. The aim of this study was to investigate the relationship between the hyperintense signal intensity in T1 MTC images and white matter damage. To this purpose, we studied potential heterogeneities in DTI values within our patients by using TBSS without a priori anatomic information.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;In 43 patients with ALS and 43 healthy control subjects, the presence or absence of T1 MTC hyperintense signal intensity was evaluated. With a DTI analysis with a TBSS approach, differences in FA distribution between the 2 groups (patients with T1 MTC hyperintense signal intensity and patients without it) compared with each other and with control subjects were investigated.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;We found regional differences in white matter FA between patients with T1 MTC hyperintense signal intensity (37.2%) and patients without it. Patients with T1 MTC abnormal signal intensity showed lower FA strictly limited to the motor network and the posterior aspect of the body of the CC without extramotor FA reductions, whereas patients without this sign showed FA reductions in several confluent regions within and outside the CST and in the whole CC.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;T1 MTC hyperintense signal intensity in the CST and posterior CC, when present, is specific for ALS and represents, among patients with ALS, a possible distinct phenotype of presentation of the disease with prominent UMN involvement.&lt;/p&gt;" />
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<meta name="twitter:title" content="A Distinct MR Imaging Phenotype in Amyotrophic Lateral Sclerosis: Correlation between T1 Magnetization Transfer Contrast Hyperintensity along the Corticospinal Tract and Diffusion Tensor Imaging Analysis" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: In the search for a diagnostic marker in ALS, we focused our attention on the hyperintense signal intensity in T1 MTC MR images along the CST, detected in some patients and not found in other patients with ALS and in control subjects. The aim of this study was to investigate the relationship between the hyperintense signal intensity in T1 MTC images and white matter damage. To this purpose, we studied potential heterogeneities in DTI values within our patients by using TBSS without a priori anatomic information.

MATERIALS AND METHODS: In 43 patients with ALS and 43 healthy control subjects, the presence or absence of T1 MTC hyperintense signal intensity was evaluated. With a DTI analysis with a TBSS approach, differences in FA distribution between the 2 groups (patients with T1 MTC hyperintense signal intensity and patients without it) compared with each other and with control subjects were investigated.

RESULTS: We found regional differences in white matter FA between patients with T1 MTC hyperintense signal intensity (37.2%) and patients without it. Patients with T1 MTC abnormal signal intensity showed lower FA strictly limited to the motor network and the posterior aspect of the body of the CC without extramotor FA reductions, whereas patients without this sign showed FA reductions in several confluent regions within and outside the CST and in the whole CC.

CONCLUSIONS: T1 MTC hyperintense signal intensity in the CST and posterior CC, when present, is specific for ALS and represents, among patients with ALS, a possible distinct phenotype of presentation of the disease with prominent UMN involvement.

ALS
:   amyotrophic lateral sclerosis
CC
:   corpus callosum
CST
:   corticospinal tract
FA
:   fractional anisotropy
FMRIB
:   Functional MR Imaging of the Brain
FSL
:   FMRIB Software Library
LMN
:   lower motor neuron
MNI
:   Montreal Neurological Institute
MT
:   magnetization transfer
MTC
:   magnetization transfer contrast
MTR
:   magnetization transfer ratio
PD
:   proton attenuation
PLS
:   primary lateral sclerosis
SE
:   spin-echo
TBSS
:   tract-based spatial statistics
UMN
:   upper motor neuron" />
<meta name="og-title" property="og:title" content="A Distinct MR Imaging Phenotype in Amyotrophic Lateral Sclerosis: Correlation between T1 Magnetization Transfer Contrast Hyperintensity along the Corticospinal Tract and Diffusion Tensor Imaging Analysis" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/33/4/733" />
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<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: In the search for a diagnostic marker in ALS, we focused our attention on the hyperintense signal intensity in T1 MTC MR images along the CST, detected in some patients and not found in other patients with ALS and in control subjects. The aim of this study was to investigate the relationship between the hyperintense signal intensity in T1 MTC images and white matter damage. To this purpose, we studied potential heterogeneities in DTI values within our patients by using TBSS without a priori anatomic information.

MATERIALS AND METHODS: In 43 patients with ALS and 43 healthy control subjects, the presence or absence of T1 MTC hyperintense signal intensity was evaluated. With a DTI analysis with a TBSS approach, differences in FA distribution between the 2 groups (patients with T1 MTC hyperintense signal intensity and patients without it) compared with each other and with control subjects were investigated.

RESULTS: We found regional differences in white matter FA between patients with T1 MTC hyperintense signal intensity (37.2%) and patients without it. Patients with T1 MTC abnormal signal intensity showed lower FA strictly limited to the motor network and the posterior aspect of the body of the CC without extramotor FA reductions, whereas patients without this sign showed FA reductions in several confluent regions within and outside the CST and in the whole CC.

CONCLUSIONS: T1 MTC hyperintense signal intensity in the CST and posterior CC, when present, is specific for ALS and represents, among patients with ALS, a possible distinct phenotype of presentation of the disease with prominent UMN involvement.

ALS
:   amyotrophic lateral sclerosis
CC
:   corpus callosum
CST
:   corticospinal tract
FA
:   fractional anisotropy
FMRIB
:   Functional MR Imaging of the Brain
FSL
:   FMRIB Software Library
LMN
:   lower motor neuron
MNI
:   Montreal Neurological Institute
MT
:   magnetization transfer
MTC
:   magnetization transfer contrast
MTR
:   magnetization transfer ratio
PD
:   proton attenuation
PLS
:   primary lateral sclerosis
SE
:   spin-echo
TBSS
:   tract-based spatial statistics
UMN
:   upper motor neuron" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node11886--5" data-node-nid="11886" id="top-node-11886--6596852838" data-pisa="ajnr;33/4/733" data-pisa-master="ajnr;ajnr.A2855" data-apath="/ajnr/33/4/733.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title">A Distinct MR Imaging Phenotype in Amyotrophic Lateral Sclerosis: Correlation between T1 Magnetization Transfer Contrast Hyperintensity along the Corticospinal Tract and Diffusion Tensor Imaging Analysis</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">G. Carrara</span>, <span class="highwire-citation-author" data-delta="1">C. Carapelli</span>, <span class="highwire-citation-author" data-delta="2">F. Venturi</span>, <span class="highwire-citation-author" data-delta="3">M.M. Ferraris</span>, <span class="highwire-citation-author" data-delta="4">L. Lequio</span>, <span class="highwire-citation-author" data-delta="5">A. Chiò</span>, <span class="highwire-citation-author" data-delta="6">A. Calvo</span>, <span class="highwire-citation-author" data-delta="7">S. Sirgiovanni</span>, <span class="highwire-citation-author" data-delta="8">A. Cistaro</span> and <span class="highwire-citation-author" data-delta="9">M.C. Valentini</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">April 2012,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">33 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(4) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">733-739; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2855 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-11886--6596852838" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">G. Carrara </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=G.%2BCarrara%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=Carrara%20G&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%3AG.%2BCarrara%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">C. 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<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> In the search for a diagnostic marker in ALS, we focused our attention on the hyperintense signal intensity in T1 MTC MR images along the CST, detected in some patients and not found in other patients with ALS and in control subjects. The aim of this study was to investigate the relationship between the hyperintense signal intensity in T1 MTC images and white matter damage. To this purpose, we studied potential heterogeneities in DTI values within our patients by using TBSS without a priori anatomic information.</p>
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<p id="p-3"><strong>MATERIALS AND METHODS:</strong> In 43 patients with ALS and 43 healthy control subjects, the presence or absence of T1 MTC hyperintense signal intensity was evaluated. With a DTI analysis with a TBSS approach, differences in FA distribution between the 2 groups (patients with T1 MTC hyperintense signal intensity and patients without it) compared with each other and with control subjects were investigated.</p>
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<p id="p-4"><strong>RESULTS:</strong> We found regional differences in white matter FA between patients with T1 MTC hyperintense signal intensity (37.2%) and patients without it. Patients with T1 MTC abnormal signal intensity showed lower FA strictly limited to the motor network and the posterior aspect of the body of the CC without extramotor FA reductions, whereas patients without this sign showed FA reductions in several confluent regions within and outside the CST and in the whole CC.</p>
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<p id="p-5"><strong>CONCLUSIONS:</strong> T1 MTC hyperintense signal intensity in the CST and posterior CC, when present, is specific for ALS and represents, among patients with ALS, a possible distinct phenotype of presentation of the disease with prominent UMN involvement.</p>
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<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">CC<span class="def-item-dt-sep"></span></dt><dd>corpus callosum<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">CST<span class="def-item-dt-sep"></span></dt><dd>corticospinal tract<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">FA<span class="def-item-dt-sep"></span></dt><dd>fractional anisotropy<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">FMRIB<span class="def-item-dt-sep"></span></dt><dd>Functional MR Imaging of the Brain<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">FSL<span class="def-item-dt-sep"></span></dt><dd>FMRIB Software Library<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">LMN<span class="def-item-dt-sep"></span></dt><dd>lower motor neuron<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">MNI<span class="def-item-dt-sep"></span></dt><dd>Montreal Neurological Institute<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">MT<span class="def-item-dt-sep"></span></dt><dd>magnetization transfer<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">MTC<span class="def-item-dt-sep"></span></dt><dd>magnetization transfer contrast<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">MTR<span class="def-item-dt-sep"></span></dt><dd>magnetization transfer ratio<span class="def-item-dd-sep"></span></dd><dt id="def-item-12">PD<span class="def-item-dt-sep"></span></dt><dd>proton attenuation<span class="def-item-dd-sep"></span></dd><dt id="def-item-13">PLS<span class="def-item-dt-sep"></span></dt><dd>primary lateral sclerosis<span class="def-item-dd-sep"></span></dd><dt id="def-item-14">SE<span class="def-item-dt-sep"></span></dt><dd>spin-echo<span class="def-item-dd-sep"></span></dd><dt id="def-item-15">TBSS<span class="def-item-dt-sep"></span></dt><dd>tract-based spatial statistics<span class="def-item-dd-sep"></span></dd><dt id="def-item-16">UMN<span class="def-item-dt-sep"></span></dt><dd>upper motor neuron</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2012 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/33/4/733.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">A Distinct MR Imaging Phenotype in Amyotrophic Lateral Sclerosis: Correlation between T1 Magnetization Transfer Contrast Hyperintensity along the Corticospinal Tract and Diffusion Tensor Imaging Analysis</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Carrara</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Carapelli</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Venturi</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">M.M.</span> <span class="nlm-surname">Ferraris</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Lequio</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Chiò</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Calvo</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Sirgiovanni</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Cistaro</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">M.C.</span> <span class="nlm-surname">Valentini</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Apr 2012, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">33 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(4) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">733-739; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2855 </span></div>
  
  
  
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      <div class="highwire-cite-title">A Distinct MR Imaging Phenotype in Amyotrophic Lateral Sclerosis: Correlation between T1 Magnetization Transfer Contrast Hyperintensity along the Corticospinal Tract and Diffusion Tensor Imaging Analysis</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Carrara</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Carapelli</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Venturi</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">M.M.</span> <span class="nlm-surname">Ferraris</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Lequio</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Chiò</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Calvo</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Sirgiovanni</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Cistaro</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">M.C.</span> <span class="nlm-surname">Valentini</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Apr 2012, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">33 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(4) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">733-739; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2855 </span></div>
  
  
  
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