Amide signal intensities may be reduced in the motor cortex and the corticospinal tract of ALS patients
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MAGNETIC RESONANCE
Amide signal intensities may be reduced in the motor cortex and the corticospinal tract of ALS patients Zhuozhi Dai 1,2 & Sanjay Kalra 3 & Dennell Mah 3 & Peter Seres 2 & Hongfu Sun 4 & Renhua Wu 1 & Alan H. Wilman 2 Received: 6 February 2020 / Revised: 21 July 2020 / Accepted: 28 August 2020 # European Society of Radiology 2020
Abstract Objectives The aim of the study is to assess amide concentration changes in ALS patients compared with healthy controls by using quantitative amide proton transfer (APT) and multiparameter magnetic resonance imaging, and testing its correlation with clinical scores. Methods Sixteen ALS patients and sixteen healthy controls were recruited as part of the Canadian ALS Neuroimaging Consortium, and multimodal magnetic resonance imaging was performed at 3 T, including APT and diffusion imaging. Lorentz fitting was used to quantify the amide effect. Clinical disability was evaluated using the revised ALS functional rating scale (ALSFRS-R), and its correlation with image characteristics was assessed. The diagnostic performance of different imaging parameters was evaluated with receiver operating characteristic analysis. Results Our results showed that the amide peak was significantly different between the motor cortex and other gray matter territories within the brain of ALS patients (p < 0.001). Compared with controls, amide signal intensities in ALS were significantly reduced in the motor cortex (p < 0.001) and corticospinal tract (p = 0.046), while abnormalities were not detected using routine imaging methods. There was no significant correlation between amide and ALSFRS-R score. The diagnostic accuracy of the amide peak was superior to that of diffusion imaging. Conclusions This study demonstrated changes of amide signal intensities in the motor cortex and corticospinal tract of ALS patients. Key Points • The neurodegenerative disease amyotrophic lateral sclerosis (ALS) has a lack of objective imaging indicators for diagnosis and assessment. • Analysis of amide proton transfer imaging revealed changes in the motor cortex and corticospinal tract of ALS patients that were not visible on standard magnetic resonance imaging. • The diagnostic accuracy of the amide peak was superior to that of diffusion imaging. Keywords Amyotrophic lateral sclerosis . Magnetic resonance imaging . Brain
* Renhua Wu [email protected] * Alan H. Wilman [email protected] 1
Department of Radiology, 2nd Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China
2
Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta T6G 2V2, Canada
3
Department of Medicine (Neurology), University of Alberta, Edmonton, Alberta T6G 2S2, Canada
4
School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Queensland 4072, Australia
Abbreviations ADC Apparent diffusion coefficient ALS Amyotrophic lateral sclerosis ALSFRS-R Revised ALS functional rating scale ANCOVA Analysis of covariance APT Amide proton transfer
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