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Abstract
Background: the study of paraspinal muscles is pivotal for the diagnosis and staging of Amyotrophic Lateral Sclerosis (ALS), and is usually performed by electromyography. Objective: to evaluate the role of paraspinal muscle MRI as a diagnostic biomarker in ALS. Methods: we evaluated T1-w images of newly diagnosed ALS patients (n = 14), age-matched healthy controls (n = 11), patients affected by inflammatory myopathy (n = 10), and lumbar radiculopathy (n = 19), and compared them semiquantitatively by using the Mercuri Scale. Results: a significant difference in the appearance of the psoas muscle was observed between ALS patients and patients with radiculopathy (p = 0.003); after stratifying ALS patients into spinal and bulbar onsets, we found a significant difference in the appearance of the longissimus dorsi muscle between the spinal onset ALS subgroup and bulbar onset ALS subgroup (p = 0.0245), while no difference was found for multifidus (p = 0.1441), iliocostal (p = 0.0655), and psoas muscles (p = 0.0813) between the cohort subgroups. Conclusions: paraspinal T1-w MRI could help to distinguish spinal ALS patients from healthy and pathological controls. Specifically, the study of longissimus dorsi could play the role of a diagnostic ALS biomarker.
Highlights
The paraspinal muscles have an essential role in the stabilization of the spine, the conservation of the correct posture, and the fluency of the trunk movements [1]
Clinical assessment helps in the classification of specific patterns of involvement (i.e., Pisa syndrome, camptocormia), whereas electromyography can be useful in the evaluation of superficial muscles at the thoracic or lumbar level, as well as in estimating the severity of the disease [2,3]
The evaluation of paraspinal muscles is essential during the diagnostic phase and follow up of patients affected by Amyotrophic Lateral Sclerosis (ALS), in order to demonstrate the involvement of the thoracic domain and define the severity of the disease [6]
Summary
The paraspinal muscles have an essential role in the stabilization of the spine, the conservation of the correct posture, and the fluency of the trunk movements [1]. The appearance of paraspinal muscles vary from person to person due to different variables (i.e., sex, body weight, physical activity) [1]. The evaluation of these muscles can be helpful in the diagnosis of pathological conditions, though their clinical assessment may be difficult to perform. The evaluation of paraspinal muscles is essential during the diagnostic phase and follow up of patients affected by Amyotrophic Lateral Sclerosis (ALS), in order to demonstrate the involvement of the thoracic domain and define the severity of the disease [6]. A recent pilot cross-sectional study performed by our group showed no difference between T1-w paraspinal muscles images of ALS patients (n = 10) and healthy controls (n = 9) [8]
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