To provide an overview of the operational structure of the Canadian ALS Neuroimaging Consortium (CALSNIC), and an update on the baseline demographics and imaging characteristics of the currently enrolled participants.

Prior studies support the potential use of several advanced MR modalities as biomarkers of disease prognosis, progression, and pharmacodynamic effect. These have been single centre studies resulting in biased cohorts with limited generalizability of the findings to the broader ALS population. In response to this, the Canadian ALS Neuroimaging Consortium (CALSNIC) was established with the primary objective of providing a neuroimaging platform to conduct prospective multicenter biomarker validation studies.

Physical examination, neuropsychological and imaging protocols were standardized across 8 sites (University of Alberta, University of British Columbia, University of Calgary, Western University, University of Toronto, McGill University, University of Laval, and University of Miami) for two prospective, longitudinal studies in ALS (CALSNIC-1, CALSNIC-2). The multimodal MRI protocols include T1, DTI, MRS, and fMRI with harmonized parameters for scanners operating at 3 Tesla.  

Harmonization of MRI and clinical protocols was completed in 2014 for CALSNIC-1. At this time, CALSNIC-2 is operational at 7 of 8 sites. To date, a total of 260 participants have enrolled in CALSNIC-1 & 2 (150 ALS, 110 healthy controls). MRS revealed reduced neuronal integrity in the motor cortex, voxel based morphometry revealed reduced gray matter density in the precentral gyrus, and DTI revealed reduced white matter integrity in the corticospinal tract. Imaging abnormalities were present to a lesser degree outside of the motor system, mostly in frontotemporal regions.

CALSNIC is a multicenter clinical research platform designed for deep phenotyping in ALS with clinical, neurocognitive, and imaging elements. It has laid the foundation for collaborative imaging-based clinical and translational research at an international level.