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Is the Hypointensity in Motor Cortex the Hallmark of Amyotrophic Lateral Sclerosis?
Boll, Marie Catherine; Marrufo Meléndez, Oscar René; Rios, Camilo; Maciel Zenil, Jesus; de Alba, Yara.
Afiliação
  • Boll MC; Department of Neurology, Laboratory of Clinical Investigation,Instituto Nacional de Neurología y Neurocirugía MVS,Mexico City,Mexico.
  • Marrufo Meléndez OR; Department of Neuroimaging,Instituto Nacional de Neurologia y Neurocirugia MVS,Mexico City,Mexico.
  • Rios C; Department of Neurochemistry,Instituto Nacional de Neurología y Neurocirugía - MVS,Mexico City,Mexico.
  • Maciel Zenil J; Laboratory of Clinical Investigation,Instituto Nacional de Neurología y Neurocirugía MVS,Mexico City,Mexico.
  • de Alba Y; Laboratory of Clinical Investigation,Instituto Nacional de Neurología y Neurocirugía MVS,Mexico City,Mexico.
Can J Neurol Sci ; 46(2): 166-173, 2019 03.
Article em En | MEDLINE | ID: mdl-30724145
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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imageamento por Ressonância Magnética / Imageamento Tridimensional / Esclerose Lateral Amiotrófica / Córtex Motor Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Can J Neurol Sci Ano de publicação: 2019 Tipo de documento: Article País de afiliação: México País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imageamento por Ressonância Magnética / Imageamento Tridimensional / Esclerose Lateral Amiotrófica / Córtex Motor Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Can J Neurol Sci Ano de publicação: 2019 Tipo de documento: Article País de afiliação: México País de publicação: Reino Unido