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Region-specific impairment of the cervical spinal cord (SC) in amyotrophic lateral sclerosis: A preliminary study using SC templates and quantitative MRI (diffusion tensor imaging/inhomogeneous magnetization transfer).
NMR Biomed. 2017 Dec; 30(12)NB

Abstract

In this preliminary study, our objective was to investigate the potential of high-resolution anatomical imaging, diffusion tensor imaging (DTI) and conventional/inhomogeneous magnetization transfer imaging [magnetization transfer (MT)/inhomogeneous magnetization transfer (ihMT)] at 3 T, analyzed with template-extracted regions of interest, to measure the atrophy and structural changes of white (WM) and gray (GM) matter spinal cord (SC) occurring in patients with amyotrophic lateral sclerosis (ALS). Ten patients with ALS and 20 age-matched healthy controls were recruited. SC GM and WM areas were automatically segmented using dedicated templates. Atrophy indices were evaluated from T2 *-weighted images at each vertebral level from cervical C1 to C6. DTI and ihMT metrics were quantified within the corticospinal tract (CST), posterior sensory tract (PST) and anterior GM (aGM) horns at the C2 and C5 levels. Clinical disabilities of patients with ALS were evaluated using the Revised ALS Functional Rating Scale, upper motor neuron (UMN) and Medical Research Council scorings, and correlated with MR metrics. Compared with healthy controls, GM and WM atrophy was observed in patients with ALS, especially at lower cervical levels, where a strong correlation was also observed between GM atrophy and the UMN score (R = -0.75, p = 0.05 at C6). Interestingly, a significant decrease in ihMT ratio was found in all regions of interest (p < 0.0008), fractional anisotropy (FA) and MT ratios decreased significantly in CST, especially at C5 (p < 0.005), and λ// (axial diffusivity) decreased significantly in CST (p = 0.0004) and PST (p = 0.003) at C2. Strong correlations between MRI metrics and clinical scores were also found (0.47 < |R| < 0.87, p < 0.05). Altogether, these preliminary results suggest that high-resolution anatomical imaging and ihMT imaging, in addition to DTI, are valuable for the characterization of SC tissue impairment in ALS. In this study, in addition to an important SC WM demyelination, we also observed, for the first time in ALS, impairments of cervical aGM.

Authors+Show Affiliations

Aix-Marseille Université, CNRS, APHM, CRMBM, Hôpital de la Timone, CEMEREM, Marseille, France. iLab-Spine International Associated Laboratory, Marseille-Montreal, France-Canada. Aix-Marseille Université, IFSTTAR, LBA UMR T 24, Marseille, France.Centre de Référence des Maladies neuro-musculaires et de la SLA, Hopital de La Timone, Marseille, France.Aix-Marseille Université, CNRS, APHM, CRMBM, Hôpital de la Timone, CEMEREM, Marseille, France. iLab-Spine International Associated Laboratory, Marseille-Montreal, France-Canada. Aix-Marseille Université, IFSTTAR, LBA UMR T 24, Marseille, France.Aix-Marseille Université, CNRS, APHM, CRMBM, Hôpital de la Timone, CEMEREM, Marseille, France.Aix-Marseille Université, CNRS, APHM, CRMBM, Hôpital de la Timone, CEMEREM, Marseille, France.Aix-Marseille Université, CNRS, APHM, CRMBM, Hôpital de la Timone, CEMEREM, Marseille, France.Aix-Marseille Université, CNRS, APHM, CRMBM, Hôpital de la Timone, CEMEREM, Marseille, France.Centre de Référence des Maladies neuro-musculaires et de la SLA, Hopital de La Timone, Marseille, France. Aix Marseille Université, INSERM, GMGF, Marseille, France.Centre de Référence des Maladies neuro-musculaires et de la SLA, Hopital de La Timone, Marseille, France.Aix-Marseille Université, CNRS, APHM, CRMBM, Hôpital de la Timone, CEMEREM, Marseille, France. iLab-Spine International Associated Laboratory, Marseille-Montreal, France-Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28926131

Citation

Rasoanandrianina, Henitsoa, et al. "Region-specific Impairment of the Cervical Spinal Cord (SC) in Amyotrophic Lateral Sclerosis: a Preliminary Study Using SC Templates and Quantitative MRI (diffusion Tensor Imaging/inhomogeneous Magnetization Transfer)." NMR in Biomedicine, vol. 30, no. 12, 2017.
Rasoanandrianina H, Grapperon AM, Taso M, et al. Region-specific impairment of the cervical spinal cord (SC) in amyotrophic lateral sclerosis: A preliminary study using SC templates and quantitative MRI (diffusion tensor imaging/inhomogeneous magnetization transfer). NMR Biomed. 2017;30(12).
Rasoanandrianina, H., Grapperon, A. M., Taso, M., Girard, O. M., Duhamel, G., Guye, M., Ranjeva, J. P., Attarian, S., Verschueren, A., & Callot, V. (2017). Region-specific impairment of the cervical spinal cord (SC) in amyotrophic lateral sclerosis: A preliminary study using SC templates and quantitative MRI (diffusion tensor imaging/inhomogeneous magnetization transfer). NMR in Biomedicine, 30(12). https://doi.org/10.1002/nbm.3801
Rasoanandrianina H, et al. Region-specific Impairment of the Cervical Spinal Cord (SC) in Amyotrophic Lateral Sclerosis: a Preliminary Study Using SC Templates and Quantitative MRI (diffusion Tensor Imaging/inhomogeneous Magnetization Transfer). NMR Biomed. 2017;30(12) PubMed PMID: 28926131.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Region-specific impairment of the cervical spinal cord (SC) in amyotrophic lateral sclerosis: A preliminary study using SC templates and quantitative MRI (diffusion tensor imaging/inhomogeneous magnetization transfer). AU - Rasoanandrianina,Henitsoa, AU - Grapperon,Aude-Marie, AU - Taso,Manuel, AU - Girard,Olivier M, AU - Duhamel,Guillaume, AU - Guye,Maxime, AU - Ranjeva,Jean-Philippe, AU - Attarian,Shahram, AU - Verschueren,Annie, AU - Callot,Virginie, Y1 - 2017/09/19/ PY - 2017/05/11/received PY - 2017/07/24/revised PY - 2017/08/07/accepted PY - 2017/9/20/pubmed PY - 2018/8/10/medline PY - 2017/9/20/entrez KW - ALS KW - GM atrophy KW - diffusion tensor imaging KW - inhomogeneous magnetization transfer KW - motor neuron KW - spinal cord KW - spinal cord templates JF - NMR in biomedicine JO - NMR Biomed VL - 30 IS - 12 N2 - In this preliminary study, our objective was to investigate the potential of high-resolution anatomical imaging, diffusion tensor imaging (DTI) and conventional/inhomogeneous magnetization transfer imaging [magnetization transfer (MT)/inhomogeneous magnetization transfer (ihMT)] at 3 T, analyzed with template-extracted regions of interest, to measure the atrophy and structural changes of white (WM) and gray (GM) matter spinal cord (SC) occurring in patients with amyotrophic lateral sclerosis (ALS). Ten patients with ALS and 20 age-matched healthy controls were recruited. SC GM and WM areas were automatically segmented using dedicated templates. Atrophy indices were evaluated from T2 *-weighted images at each vertebral level from cervical C1 to C6. DTI and ihMT metrics were quantified within the corticospinal tract (CST), posterior sensory tract (PST) and anterior GM (aGM) horns at the C2 and C5 levels. Clinical disabilities of patients with ALS were evaluated using the Revised ALS Functional Rating Scale, upper motor neuron (UMN) and Medical Research Council scorings, and correlated with MR metrics. Compared with healthy controls, GM and WM atrophy was observed in patients with ALS, especially at lower cervical levels, where a strong correlation was also observed between GM atrophy and the UMN score (R = -0.75, p = 0.05 at C6). Interestingly, a significant decrease in ihMT ratio was found in all regions of interest (p < 0.0008), fractional anisotropy (FA) and MT ratios decreased significantly in CST, especially at C5 (p < 0.005), and λ// (axial diffusivity) decreased significantly in CST (p = 0.0004) and PST (p = 0.003) at C2. Strong correlations between MRI metrics and clinical scores were also found (0.47 < |R| < 0.87, p < 0.05). Altogether, these preliminary results suggest that high-resolution anatomical imaging and ihMT imaging, in addition to DTI, are valuable for the characterization of SC tissue impairment in ALS. In this study, in addition to an important SC WM demyelination, we also observed, for the first time in ALS, impairments of cervical aGM. SN - 1099-1492 UR - https://www.unboundmedicine.com/medline/citation/28926131/Region_specific_impairment_of_the_cervical_spinal_cord__SC__in_amyotrophic_lateral_sclerosis:_A_preliminary_study_using_SC_templates_and_quantitative_MRI__diffusion_tensor_imaging/inhomogeneous_magnetization_transfer__ L2 - https://doi.org/10.1002/nbm.3801 DB - PRIME DP - Unbound Medicine ER -