Thivard Lionel, Pradat Pierre-François, Lehéricy Stéphane, Lacomblez Lucette, Dormont Didier, Chiras Jacques, Benali Habib, Meininger Vincent
INSERM U739, Faculté de Médecine Pitié-Salpêtrière, 75013, Paris, France.
J Neurol Neurosurg Psychiatry. 2007 Aug;78(8):889-92. doi: 10.1136/jnnp.2006.101758.
The aim of this study was to investigate the extent of cortical and subcortical lesions in amyotrophic lateral sclerosis (ALS) using, in combination, voxel based diffusion tensor imaging (DTI) and voxel based morphometry (VBM). We included 15 patients with definite or probable ALS and 25 healthy volunteers. Patients were assessed using the revised ALS Functional Rating Scale (ALSFRS-R). In patients, reduced fractional anisotropy was found in bilateral corticospinal tracts, the left insula/ventrolateral premotor cortex, the right parietal cortex and the thalamus, which correlated with the ALSFRS-R. Increased mean diffusivity (MD) was found bilaterally in the motor cortex, the ventrolateral premotor cortex/insula, the hippocampal formations and the right superior temporal gyrus, which did not correlate with the ALSFRS-R. VBM analysis showed no changes in white matter but widespread volume decreases in grey matter in several regions exhibiting MD abnormalities. In ALS patients, our results show that subcortical lesions extend beyond the corticospinal tract and are clinically relevant.
本研究的目的是联合使用基于体素的扩散张量成像（DTI）和基于体素的形态测量学（VBM）来研究肌萎缩侧索硬化症（ALS）患者皮质和皮质下病变的范围。我们纳入了15例确诊或疑似ALS的患者以及25名健康志愿者。使用修订的ALS功能评定量表（ALSFRS-R）对患者进行评估。在患者中，双侧皮质脊髓束、左侧岛叶/腹外侧运动前区皮质、右侧顶叶皮质和丘脑的分数各向异性降低，且与ALSFRS-R相关。在双侧运动皮质、腹外侧运动前区皮质/岛叶、海马结构和右侧颞上回发现平均扩散率（MD）增加，这与ALSFRS-R无关。VBM分析显示白质无变化，但在几个出现MD异常的区域灰质广泛体积减小。在ALS患者中，我们的结果表明皮质下病变超出皮质脊髓束范围且具有临床相关性。
