Features of white matter degeneration in ALS patients with different onset and spreading pattern by using DTI

Xinyi YU; Haining LI; Qianqian Duan; Shan WU; Jiaoting Jin; Fangfang HU; Jingxia Dang; Ming Zhang; Qiuli Zhang

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Features of white matter degeneration in ALS patients with different onset and spreading pattern by using DTI

VernacularTitle:基于DTI成像的ALS不同起病类型及播散模式下白质退变的特征分析
Author: Xinyi YU ¹ ; Haining LI ¹ ; Qianqian DUAN ¹ ; Shan WU ¹ ; Jiaoting JIN ² ; Fangfang HU ² ; Jingxia DANG ² ; Ming ZHANG ¹ ; Qiuli ZHANG ¹
Author Information

1. Department of Medical Imaging, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061
2. Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
Publication Type:Journal Article
Keywords: amyotrophic lateral sclerosis; disease spreading; diffusion tensor imaging; corticospinal tract; disease heterogeneity
From: Journal of Xi'an Jiaotong University(Medical Sciences) 2023;44(5):674-680
CountryChina
Language:Chinese
Abstract: 【Objective】 To explore the characteristics of white matter degeneration in amyotrophic lateral sclerosis (ALS) patients with different onset and spreading patterns by using diffusion tensor imaging (DTI). 【Methods】 We enrolled 86 ALS patients and 44 healthy controls. The patients were divided into bulbar- and spinal-onset subgroups according to their onset site, as well as horizon, vertical, interpose/skip, and caudal-rostral subgroups based on the spreading direction of the involved regions. The white matter fiber tracts corresponding to the motor network were set as the region of interest. We used tract-based spatial statistics to evaluate differences between the above groups and the normal controls, with family-wise error (FWE) correction and P<0.05 as statistical significance. 【Results】 The white matter degeneration of ALS patients with bulbar onset was mainly limited to the corona radiation part of the corticospinal tract, while those with spinal onset showed extensive degeneration of corticospinal tract and corpus callosum Ⅲ area (FWE correction, P<0.05). In patients with horizontal and vertical dissemination, decreased integrity of the entire corticospinal tract was found, with patients in the latter group showed extra degeneration in the Ⅲ part of the corpus callosum. Restricted degeneration of the corticospinal tract within bilateral corona radiata was detected in patients with caudal-rostral and interposed/skip spreading pattens (FWE correction, P<0.05). 【Conclusion】 Different onset and disease spread patterns of ALS patients correspond to divergent brain degeneration patterns. The diagnosis, treatment, and management of ALS should fully consider the heterogeneity of the disease.