Evaluation of Motor Neuron Injury in ALS by Different Parameters of Diffusion Tensor Imaging

Yong Sang,Jingfeng Xu

doi:10.1109/access.2020.2985064

Abstract

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease involving upper and lower motoneurons selectively. The injury of lower motoneurons is closely related to the onset, progression and prognosis of ALS. Therefore, the assessment of the injury of lower motoneurons is of great significance to ALS. Diffusion tensor imaging (DTI) is a new imaging method improved and developed on the basis of diffusion weighted imaging. It uses the anisotropic principle of diffusion movement of water molecules to quantify it from multiple directions, so as to reflect the changes of fine structure and function of living tissues. It can be more objective to find the damage of the upper motor neurons, help the early diagnosis of ALS, and objectively monitor and evaluate the development and treatment of ALS. In this paper, the research and application of different parameters of diffusion tensor imaging to evaluate the motor neuron injury in ALS were studied. Patients with motor neuron injury in ALS were collected as case group and healthy volunteers as control group. The diagnostic value of different parameters of axial DTI in ALS was discussed. The FA and MD values of the pyramidal tract in ALS patients have obvious changes compared with those in healthy people. It can objectively and quantitatively evaluate the pathological changes of the pyramidal tract in ALS patients, and provide valuable information for the diagnosis of ALS. The FA value is more sensitive, and the posterior limb of the internal capsule may be the best place to evaluate the damage of the pyramidal tract. In a word, DTI can objectively and quantitatively evaluate the lesions of pyramidal tract, provide valuable information for the diagnosis of ALS, and hope to provide help for the establishment, diagnosis, evaluation, prognosis, scientific research and drug test of ALS motor nerve injury.

Highlights

Amyotrophic lateral sclerosis (ALS) is one of the most common motor neuron diseases in adults, which is more common than middle age [1], [2]
When the axons or myelin sheath of the white matter tract are involved in various lesions, the fractional anisotropy (FA) value of the involved area will be reduced to some extent, while the ADC value will be increased to some extent [47], [48]
When the axons and myelin sheath of the white matter tract are involved in various lesions, the FA value of the involved area will be reduced to some extent, while the MD value will be increased to some extent, as shown in Figure 6 and Figure 7

Summary

Introduction

Amyotrophic lateral sclerosis (ALS) is one of the most common motor neuron diseases in adults, which is more common than middle age [1], [2]. It selectively involves upper and lower motor neurons. The damage of upper motor neuron (UMN) usually starts from the cortex of motor area and premotor area, followed by the degeneration of motor fibers in pyramidal tract and the proliferation of neuroglia [6]–[8]. The damage of lower motor neuron (LMN) mostly involves brain stem and spinal cord anterior horn cells. There are complex interactions between UMN and LMN in ALS. LMN damage is an important pathophysiological process in ALS

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Conclusion