Abstract Details

Title A Longitudinal Study of Diffusion Tensor Imaging in ALS Patients

Topic Anterior Horn

Presentation(s) S36 - (-)

Poster/Presentation
Number 004

Objective

Background The role of DTI in Amyotrophic Lateral sclerosis is not clearly understood, prior studies were hindered by their small sample size and provided conflicting results they also focused on the diagnostic value of DTI. The use of DTI as a marker of disease progression has not been investigated.

Design/Methods 12 patients with ALS and 12 healthy controls were enrolled in the study. ALSFRS-R, FVC and manual muscle testing were performed at baseline and at 6 months. Patients and controls underwent two structural MRI scans at baseline and at 6 months that included a high resolution T1 and a DTI scan.

Results All ALS patients exhibited a significant DTI abnormalities at baseline and at 6 months. The area of corticospinal tract caudal to the thalamus bilaterally exhibited the most significant lower FA value at baseline. However the anisotropy for this region did not exhibit a significant change at 6 months. The change in FA correlated with the change in FVC. For the area where ALS patients showed a significant difference from control, there was a difference in radial but not in axial diffusivity suggesting that disrupted myelin tracts may be at the root of the drop in FA noted in the patients.

Conclusions DTI seems to be a sensitive tool for detecting early corticospinal tract degeneration and may help establish early diagnosis in ALS patients, however longitudinal analysis did not reveal significant change in FA values overtime. It seems that upper motor neuron damage in ALS happen very early on. DTI could be used as a surrogate marker of UMN degeneration but may not be a good marker of disease progression. Getting repeated scans in ALS patients is limited by the patient functional decline.

Authors/Disclosures
Senda Ajroud-Driss, MD, FAAN (Northwestern University) PRESENTER	Dr. Ajroud-Driss has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amylyx Pharmaceuticals. Dr. Ajroud-Driss has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. The institution of Dr. Ajroud-Driss has received research support from ALSA. Dr. Ajroud-Driss has received publishing royalties from a publication relating to health care.
Ali Mansour, MD (University of Chicago)	Dr. Mansour has nothing to disclose.
	No disclosure on file
Andreas Straube	Andreas Straube has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TEVA. Andreas Straube has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for TEVA. Andreas Straube has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Novartis.
	No disclosure on file
Jeffrey A. Allen, MD (University of Minnesota)	Dr. Allen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Argenx. Dr. Allen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for csl behring. Dr. Allen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Takeda. Dr. Allen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Grifols. Dr. Allen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alnylam. Dr. Allen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Allen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astra Zeneca. Dr. Allen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson and Johnson. Dr. Allen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alexion. Dr. Allen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Annexon. Dr. Allen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Immunovant. Dr. Allen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for CSL Behring. Dr. Allen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Annexon. Dr. Allen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Octapharma. Dr. Allen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Takeda. Dr. Allen has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. Dr. Allen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for CSL behring. Dr. Allen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Takeda. Dr. Allen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Alnyla,m. Dr. Allen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Alexion.
Robert L. Sufit, MD	No disclosure on file
Scott L. Heller, MD	No disclosure on file
Teepu Siddique, MD, FAAN	No disclosure on file
	No disclosure on file

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