Abstract Details

Title Interhemispheric Structural Network Abnormalities Differentiate PLS from ALS

Topic Anterior Horn

Presentation(s) P06 - (-)

Poster/Presentation
Number 133

Objective

Background BACKGROUND: The distinction between PLS and ALS relies primarily on recognition of symptoms and signs supported by non-specific, ancillary laboratory data.

Design/Methods DESIGN/METHODS: DT MRI was obtained from 26 PLS patients, 28 ALS patients and 35 healthy controls. Tractography was used to obtain mean fractional anisotropy (FA) of the corticospinal tracts (CST) and corpus callosum (CC). The CC was divided into three portions to segment the callosal fibres linking the primary motor cortices (PMC), lateral premotor cortices and supplementary motor area (SMA). DT MRI diagnostic accuracy in distinguishing the two MND variants from controls and each other was tested by the Concordance (C) index using a logistic regression analysis.

Results RESULTS: The highest patient classification accuracy when PLS patients were compared with controls were FA values of the CC-PMC and CC-SMA with a C index of 0.91 and 0.90, respectively (i.e., about 90% of patients were classified correctly). CST FA values were able to classify correctly PLS patients vs. controls with a C index of 0.72. CST and CC-PMC FA values had a similar ability in distinguishing ALS patients from controls (C index of 0.66 and 0.68, respectively). When patient groups were contrasted to each other, the CC-PMC and CC-SMA FA measures provided the highest accuracy in distinguishing PLS from ALS cases (C index of 0.74 and 0.79, respectively).

Conclusions CONCLUSIONS: DT MRI values from "critical" WM tracts may contribute to the diagnostic work-up of MND. The striking different involvement of the motor collosal fibers in PLS and ALS suggests CC diffusivity as a novel marker to increase confidence in diagnosing PLS and possibly to monitor its evolution.

Authors/Disclosures
PRESENTER	No disclosure on file
Federica Agosta (San Raffaele Scientific Institute)	Federica Agosta has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Philips. Federica Agosta has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier INC.
	No disclosure on file
	No disclosure on file
Adriano Chio, MD, FAAN (Dept. of Neuroscience, University of Turin)	Dr. Chio has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cytokinetics. Dr. Chio has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi. Dr. Chio has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Chio has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Corcept.
Stefano Messina, MD (Istituto Auxologico Italiano, Ospedale San Lu)	No disclosure on file
Sandro Iannaccone	No disclosure on file
Andrea Calvo, MD, PhD, FAAN (Dept. of Neuroscience, University of Turin)	Dr. Calvo has nothing to disclose.
Vincenzo Silani, MD, FAAN (University of Milan Medical School - IRCCS Istituto Auxologico Italiano)	Dr. Silani has nothing to disclose.
Massimiliano Copetti	No disclosure on file
Andrea Falini	No disclosure on file
Giancarlo Comi, MD (University Vita-Salute)	Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Aspen Healthcare. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Rewind.
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.

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