皮质脊髓束
肌萎缩侧索硬化
上运动神经元
脑干
部分各向异性
医学
磁共振弥散成像
白质
锥体束
磁共振成像
核医学
解剖
病理
内科学
放射科
疾病
作者
N. Iwata,Shigeki Aoki,Shingo Okabe,N. Arai,Yasuo Terao,Soyoung Kwak,Osamu Abe,Ichiro Kanazawa,S Tsuji,Yoshikazu Ugawa
出处
期刊:Neurology
[Ovid Technologies (Wolters Kluwer)]
日期:2008-02-11
卷期号:70 (7): 528-532
被引量:112
标识
DOI:10.1212/01.wnl.0000299186.72374.19
摘要
To assess corticospinal tract involvement in patients with amyotrophic lateral sclerosis (ALS) by correlating diffusion tensor imaging (DTI) measures with intra- and extracranial central motor conduction time (CMCT) and clinical features of the patients.We investigated 31 patients with ALS and 31 normal volunteers by DTI and measured fractional anisotropy (FA) within the corticospinal tracts and in the extramotor white matter. We measured CMCT for the first dorsal interosseous muscle and segmented it into cortical-brainstem (CTX-BS CT) and brainstem-cervical root (BS-CV CT) conduction times by magnetic brainstem stimulation at the foramen magnum level. Clinical status of each patient was evaluated with the ALS Functional Rating Scale-Revised (ALSFRS-R) and upper motor neuron (UMN) score devised for this study.We found a significant decrease of mean FA in all regions of the corticospinal tracts in patients with ALS as compared with controls. We found that FA along the corticospinal tract decreased significantly with higher UMN scores. There was no significant correlation between FA and ALSFRS-R, to which both upper and lower motoneuron involvements contribute. FA showed a significant correlation with the intracranial part of the central motor conduction (CTX-BS CT) but not with the extracranial conduction time.Fractional anisotropy reflects functional abnormality of intracranial corticospinal tracts and can be used for objective evaluation of upper motor neuron impairment in amyotrophic lateral sclerosis.
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