rss
J Neurol Neurosurg Psychiatry 2009;80:53-55 doi:10.1136/jnnp.2008.154252
  • Research paper

A longitudinal diffusion tensor MRI study of the cervical cord and brain in amyotrophic lateral sclerosis patients

  1. F Agosta1,
  2. M A Rocca1,
  3. P Valsasina1,
  4. S Sala1,
  5. D Caputo2,
  6. M Perini3,
  7. F Salvi4,
  8. A Prelle5,
  9. M Filippi1
  1. 1
    Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy
  2. 2
    Department of Neurology, Scientific Institute Fondazione Don Gnocchi, Milan, Italy
  3. 3
    Department of Neurology, Ospedale di Gallarate, Gallarate, Italy
  4. 4
    Department of Neurology, Ospedale di Bellaria, University of Bologna, Bologna, Italy
  5. 5
    Dino Ferrari Center, Department of Neuroscience, University of Milan, Milan, Italy
  1. Dr M Filippi, Neuroimaging Research Unit, Department of Neurology, Scientific Institute and University Ospedale San Raffaele, via Olgettina 60, 20132 Milan, Italy; filippi.massimo{at}hsr.it
  • Received 19 May 2008
  • Revised 11 July 2008
  • Accepted 12 August 2008
  • Published Online First 17 October 2008

Abstract

Objective: To define the temporal evolution of intrinsic tissue damage and atrophy in the cervical cord and the brain portion of the corticospinal tracts (CST) from patients with amyotrophic lateral sclerosis (ALS).

Methods: Conventional and diffusion tensor (DT) magnetic resonance imaging (MRI) of the cervical cord and brain were obtained from 17 ALS patients and 20 controls, at baseline and after a mean follow-up of 9 months. The following measurements were assessed: (a) cervical cord cross-sectional area, average mean diffusivity (MD) and average fractional anisotropy (FA); and (b) CST T2-visible hyperintensities, average MD and FA.

Results: During the follow-up, ALS patients showed a significant decrease in cord area (p = 0.003) and cord average FA (p = 0.01), and a significant increase in cord average MD (p = 0.01). In ALS patients, longitudinal changes of diffusivity measurements were not associated with cord area changes. At baseline, brain CST average MD was significantly higher in ALS patients compared with controls (p = 0.001). Brain CST diffusivity measurements remained stable over time in ALS patients and did not correlate with cord damage.

Conclusions: This study shows that progressive tissue loss and injury to the remaining tissue occur in the cervical cord of ALS patients and that these two features of ALS-related pathology are not strictly interrelated. Cord pathology in ALS patients is likely to be independent of brain changes, indicating that imaging the cervical cord may be a useful adjunctive tool to monitor ALS evolution.

Footnotes

  • Competing interests: None.

  • Ethics approval: Ethics approval was provided by the Ethical Committee of the Fondazione Don Gnochi, Milan, Italy.

  • Patient consent: Obtained.

This Article

  1. Abstract
  2. Full text
  3. PDF
  4. All versions of this article:
    1. jnnp.2008.154252v1
    2. 80/1/53 most recent

Responses

  1. Submit a response
  2. No responses published

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

BMJ Careers - Latest neurology and neurosurgery jobs