Abstract
Objective Fractal dimensionality (FD) analysis provides a quantitative description of brain structural complexity. The application of FD analysis has provided evidence of amyotrophic lateral sclerosis- (ALS-) related white matter degeneration. This study is aimed at evaluating, for the first time, FD alterations in a gray matter in ALS and determining its association with clinical parameters. Materials and Methods. This study included 22 patients diagnosed with ALS and 20 healthy subjects who underwent high-resolution T1-weighted imaging scanning. Disease severity was assessed using the revised ALS Functional Rating Scale (ALSFRS-R). The duration of symptoms and rate of disease progression were also assessed. The regional FD value was calculated by a computational anatomy toolbox and compared among groups. The relationship between cortical FD values and clinical parameters was evaluated by Spearman correlation analysis. Results ALS patients showed decreased FD values in the left precentral gyrus and central sulcus, left circular sulcus of insula (superior segment), left cingulate gyrus and sulcus (middle-posterior part), right precentral gyrus, and right postcentral gyrus. The FD values in the right precentral gyrus were positively correlated to ALSFRS-R scores (r = 0.44 and P = 0.023), whereas negatively correlated to the rate of disease progression (r = 0.44 and P = 0.023), whereas negatively correlated to the rate of disease progression (r = 0.44 and P = 0.023), whereas negatively correlated to the rate of disease progression (Conclusions Our results suggest an ALS-related reduction in structural complexity involving the gray matter. FD analysis may shed more light on the pathophysiology of ALS.
Highlights
Amyotrophic lateral sclerosis (ALS) is a severe, progressive neurodegenerative disease that involves the upper motor neurons of the motor cortex and lower motor neurons of the brain stem and spinal cord [1]
Resting-state functional MRI studies have suggested that ALS involves a reduction in spontaneous neuronal activity in the sensorimotor cortex and cingulate cortex [11,12,13], which is
Using Fractal dimensionality (FD) as an indicator, we discovered reduced cortical complexity in ALS, involving the precentral cortex, postcentral cortex, central sulcus, cingulate gyrus and sulcus, and circular sulcus of insula
Summary
Amyotrophic lateral sclerosis (ALS) is a severe, progressive neurodegenerative disease that involves the upper motor neurons of the motor cortex and lower motor neurons of the brain stem and spinal cord [1]. ALS patients present with motor neuron disease [1], such as muscle weakness and spasticity, dysarthria and dysphagia, and hyperreflexia, as well as cognitive alterations, including executive dysfunction, memory decline, and attention deficit [2]. Neuropathological studies of ALS have revealed neuronal loss and hyperplasia of astrocyte in the primary motor cortex [3]. Based on a high-resolution T1-weighted image, structural MRI analysis revealed cortical atrophy in the precentral cortex, postcentral cortex, insula, cingulate gyrus, and sulcus in ALS [4,5,6,7]. Resting-state functional MRI studies have suggested that ALS involves a reduction in spontaneous neuronal activity in the sensorimotor cortex and cingulate cortex [11,12,13], which is
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