Tags

Type your tag names separated by a space and hit enter

Corpus callosum involvement is a consistent feature of amyotrophic lateral sclerosis.
Neurology. 2010 Nov 02; 75(18):1645-52.Neur

Abstract

OBJECTIVE

While the hallmark of amyotrophic lateral sclerosis (ALS) is corticospinal tract in combination with lower motor neuron degeneration, the clinical involvement of both compartments is characteristically variable and the site of onset debated. We sought to establish whether there is a consistent signature of cerebral white matter abnormalities in heterogeneous ALS cases.

METHODS

In this observational study, diffusion tensor imaging was applied in a whole-brain analysis of 24 heterogeneous patients with ALS and well-matched healthy controls. Tract-based spatial statistics were used, with optimized voxel-based morphometry of T1 images to determine any associated gray matter involvement.

RESULTS

A consistent reduction in fractional anisotropy was demonstrated in the corpus callosum of the ALS group, extending rostrally and bilaterally to the region of the primary motor cortices, independent of the degree of clinical upper motor neuron involvement. Matched regional radial diffusivity increase supported the concept of anterograde degeneration of callosal fibers observed pathologically. Gray matter reductions were observed bilaterally in primary motor and supplementary motor regions, and also in the anterior cingulate and temporal lobe regions. A post hoc group comparison model incorporating significant values for fractional anisotropy, radial diffusivity, and gray matter was 92% sensitive, 88% specific, with an accuracy of 90%.

CONCLUSION

Callosal involvement is a consistent feature of ALS, independent of clinical upper motor neuron involvement, and may reflect independent bilateral cortical involvement or interhemispheric spread of pathology. The predominantly rostral corticospinal tract involvement further supports the concept of independent cortical degeneration even in those patients with ALS with predominantly lower motor neuron involvement clinically.

Authors+Show Affiliations

University of Oxford Centre for Functional Magnetic Resonance of the Brain, John Radcliffe Hospital, Oxford, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21041787

Citation

Filippini, N, et al. "Corpus Callosum Involvement Is a Consistent Feature of Amyotrophic Lateral Sclerosis." Neurology, vol. 75, no. 18, 2010, pp. 1645-52.
Filippini N, Douaud G, Mackay CE, et al. Corpus callosum involvement is a consistent feature of amyotrophic lateral sclerosis. Neurology. 2010;75(18):1645-52.
Filippini, N., Douaud, G., Mackay, C. E., Knight, S., Talbot, K., & Turner, M. R. (2010). Corpus callosum involvement is a consistent feature of amyotrophic lateral sclerosis. Neurology, 75(18), 1645-52. https://doi.org/10.1212/WNL.0b013e3181fb84d1
Filippini N, et al. Corpus Callosum Involvement Is a Consistent Feature of Amyotrophic Lateral Sclerosis. Neurology. 2010 Nov 2;75(18):1645-52. PubMed PMID: 21041787.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Corpus callosum involvement is a consistent feature of amyotrophic lateral sclerosis. AU - Filippini,N, AU - Douaud,G, AU - Mackay,C E, AU - Knight,S, AU - Talbot,K, AU - Turner,M R, PY - 2010/11/3/entrez PY - 2010/11/3/pubmed PY - 2010/12/14/medline SP - 1645 EP - 52 JF - Neurology JO - Neurology VL - 75 IS - 18 N2 - OBJECTIVE: While the hallmark of amyotrophic lateral sclerosis (ALS) is corticospinal tract in combination with lower motor neuron degeneration, the clinical involvement of both compartments is characteristically variable and the site of onset debated. We sought to establish whether there is a consistent signature of cerebral white matter abnormalities in heterogeneous ALS cases. METHODS: In this observational study, diffusion tensor imaging was applied in a whole-brain analysis of 24 heterogeneous patients with ALS and well-matched healthy controls. Tract-based spatial statistics were used, with optimized voxel-based morphometry of T1 images to determine any associated gray matter involvement. RESULTS: A consistent reduction in fractional anisotropy was demonstrated in the corpus callosum of the ALS group, extending rostrally and bilaterally to the region of the primary motor cortices, independent of the degree of clinical upper motor neuron involvement. Matched regional radial diffusivity increase supported the concept of anterograde degeneration of callosal fibers observed pathologically. Gray matter reductions were observed bilaterally in primary motor and supplementary motor regions, and also in the anterior cingulate and temporal lobe regions. A post hoc group comparison model incorporating significant values for fractional anisotropy, radial diffusivity, and gray matter was 92% sensitive, 88% specific, with an accuracy of 90%. CONCLUSION: Callosal involvement is a consistent feature of ALS, independent of clinical upper motor neuron involvement, and may reflect independent bilateral cortical involvement or interhemispheric spread of pathology. The predominantly rostral corticospinal tract involvement further supports the concept of independent cortical degeneration even in those patients with ALS with predominantly lower motor neuron involvement clinically. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/21041787/Corpus_callosum_involvement_is_a_consistent_feature_of_amyotrophic_lateral_sclerosis_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=21041787 DB - PRIME DP - Unbound Medicine ER -