Temporal muscle thickness and survival in patients with amyotrophic lateral sclerosis

ABSTRACTTemporal muscle thickness (TMT) is a new potential MRI biomarker, which has shown prognostic relevance in neuro-oncology. We aim at investigating the potential prognostic value of TMT in patients with Amyotrophic Lateral Sclerosis (ALS). We retrospectively evaluated 30 ALS patients, whose clinical, Magnetic Resonance Imaging (MRI) and Electrodiagnostic testing (EDX) data were available, in comparison to age-matched 30 healthy subjects. TMT calculated on T1-weighted MR images was significantly lower in ALS patients than in healthy subjects (p < 0.001), correlating with the ALS Functional Rating Scale (FRS) (p:0.018) and compound motor action potential (CMAP) (p:0.012) in the patients group. Multivariate analysis of overall survival (OS) showed that the only parameters that remained significant were TMT (p:0.002, OR 0.45, 95%vCI: 0.28–0.75) and ALS FRS-R (p:0.023, OR: 0.80, 95%CI: 0.67–0.92). TMT seems to be a promising surrogate biomarker of survival and functional status in ALS. Our data deserve further investigations in multicenter and prospective trials.KEYWORDS: Temporal muscle thickness (TMT)MRI biomarkeramyotrophic lateral sclerosis (ALS)muscle losssarcopeniasurvival Ethical approvalThe study was approved by the local Ethics Committee (Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona), and all procedures were in accordance with the 1964 Declaration of Helsinki.Informed consentInformed consent was obtained from all individual participants included in the study.Disclosure statementNo potential conflict of interest was reported by the author(s).Author contributionsAuthor contributions included conception and study design (C.V, A.T and P.B,), data collection or acquisition (C.V, D.R, S.T, F.A and A.L), statistical analysis (V.N and C.V), interpretation of results (C.V, A.T, V.N. and P.B), drafting the manuscript work or revising it critically for important intellectual content (C.V and P.B) and approval of final version to be published and agreed to be accountable for the integrity and accuracy of all aspects of the work (All authors).Additional informationFundingThe author(s) reported that there is no funding associated with the work featured in this article.Notes on contributorsClaudia VinciguerraClaudia Vinciguerra graduated in medicine and trained as a neurologist at the University of Siena, Italy, and then completed a PhD in neuroscience at the University of Florence, Italy.Actually she is working as Neurologist at the Neurology Unit of Univeristy Hospital of Salerno, with a research focus on Neuromuscular Disorders, Clinical Neurophysiology, Electromyography and Evoked Potential, Neurorehabilitation (Music Therapy).Antonella TorielloAntonella Toriello graduated in medicine and trained as a neurologist at the University of Naples , Italy, Actually she is working as Neurologist at the Neurology Unit of Univeristy Hospital of Salerno, with a research focus on Neuromuscular Disorders in particular Amyotrophic Lateral Sclerosis.Valerio NardoneValerio Nardone graduated in medicine and trained as a radiation oncologist at the University of Siena, Italy. More recently he obtained he national scientific qualification an Associate Professor (procedure for the Italian University Professor position recruiting, based on rigorous scientific qualification criteria.Actually he is working as senior researcher at University of Campania Luigi Vanvitelli, Naples, Italy with a research focus on radiotherapy and oncology in a wide spectrum of diseas, in particular brain cancer, neuroimaging and statistical analysis.Daniele RomanoDaniele Romano graduated in medicine and trained as radiologist at University of Sassari, Italy.-Fellow of EBNI (European board of neurointerventionist). ASN (Accademic National Scientific Abilitation) 2020/2030.Actually he is working as Interventional and Diagnostic Neuroradiologist (Spine and Vascular procedures; specific application for diagnostic and endovascular treatment of acute ischemic Stroke and endovascular treatment of retinoblastoma, MR/MRS/CT) at University Hospital of Salerno, Italy.Salvatore TartaglioneSalvatore Tartaglione graduated in medicine and trained as radiologist at University of Campania Luigi Vanvitelli, Naples, Italy. Actually he is working as Diagnostic Neuroradiologist (MR/MRS/CT) at University Hospital of Salerno, Italy.Filomena AbateFilomena Abate graduated in medicine and trained as neurologist at University of Salerno, Italy.Actually he is working as PhD student at University Hospital of Salerno, with a research focus on Movement disorders.Annamaria LandolfiAnnamaria Landolfi graduated in medicine and trained as neurologist at University of Salerno, Italy. Actually he is working as fellow neurologist at University Hospital of Salerno, with a research focus on Movement disorders and Neuromuscular Disease.Paolo BaronePaolo Barone graduated in medicine and trained as a neurologist at the University of Naples, Italy, and then completed a PhD in neuroscience and a postdoctoral fellowship at the National Institutes of Health, Bethesda, MA, USA. He is professor of neurology and chief of the movement disorders at the University of Salerno, with a research focus on the Movement Disorders, progression and neuropharmacology of Parkinson's disease.