Is the Hypointensity in Motor Cortex the Hallmark of Amyotrophic Lateral Sclerosis?
Can J Neurol Sci
; 46(2): 166-173, 2019 03.
Article
en En
| MEDLINE
| ID: mdl-30724145
ABSTRACT
BACKGROUND:
Amyotrophic lateral sclerosis (ALS) is a devastating disease that targets motor neurons. Upper motor neurons degeneration is pathologically characterized by brain iron accumulation. Signal attenuation in the shape of a ribbon at the posterior border of the precentral gyrus can be observed on conventional magnetic resonance imaging (MRI) sequences including T2-weighted sequence.METHODS:
With the aim to know the qualities of this potential marker of ALS, we conducted a prospective study. Patients with definite ALS in the age range of 40-70 years and healthy controls underwent 3T brain MRI using a standardized sequence. A second MRI was performed 18 months later under the same conditions in the patients with ALS.RESULTS:
Most of the patients with ALS (91.66%) exhibited a "black ribbon" (BR) with an average area of 79.98 mm3. Signal attenuation discriminated ALS with a mean value of 63.97 arbitrary units (AU) on the left BR (95% CI 60.67-67.27), a mean value of 59.15 AU (95% CI 54.78-63.53) on the right BR, and a significant difference with control subjects presenting a mean value of 107.85 AU (p < 0.001). The optimal cut-off point for differentiating patients with ALS from controls (sensitivity, 0.92; specificity, 0.93) was 83 AU. Forced vital capacity and muscle strength in the contralateral upper extremity were significantly correlated with the ribbon intensity in ALS. Patients who underwent a second study exhibited significant changes in the BR related to the rapid evolution of the disease.CONCLUSIONS:
This marker represents a valuable tool for the selection of candidates and their follow-up in clinical trials.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Imagen por Resonancia Magnética
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Imagenología Tridimensional
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Esclerosis Amiotrófica Lateral
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Corteza Motora
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Can J Neurol Sci
Año:
2019
Tipo del documento:
Article
País de afiliación:
México