Pradat Pierre-François, El Mendili Mohamed-Mounir
Sorbonne Universités, UPMC Universités Paris 06, UMR 7371, UMR-S 1146, LIB, 75005 Paris, France ; CNRS, UMR 7371, LIB, 75005 Paris, France ; INSERM, UMR-S 1146, LIB, 75005 Paris, France ; Département des Maladies du Système Nerveux, Hôpital Pitié-Salpêtrière (AP-HP), 75005 Paris, France.
Sorbonne Universités, UPMC Universités Paris 06, UMR 7371, UMR-S 1146, LIB, 75005 Paris, France ; CNRS, UMR 7371, LIB, 75005 Paris, France ; INSERM, UMR-S 1146, LIB, 75005 Paris, France.
Biomed Res Int. 2014;2014:467560. doi: 10.1155/2014/467560. Epub 2014 Apr 17.
Neuroimaging allows investigating the extent of neurological systems degeneration in amyotrophic lateral sclerosis (ALS). Advanced MRI methods can detect changes related to the degeneration of upper motor neurons but have also demonstrated the participation of other systems such as the sensory system or basal ganglia, demonstrating in vivo that ALS is a multisystem disorder. Structural and functional imaging also allows studying dysfunction of brain areas associated with cognitive signs. From a biomarker perspective, numerous studies using diffusion tensor imaging showed a decrease of fractional anisotropy in the intracranial portion of the corticospinal tract but its diagnostic value at the individual level remains limited. A multiparametric approach will be required to use MRI in the diagnostic workup of ALS. A promising avenue is the new methodological developments of spinal cord imaging that has the advantage to investigate the two motor system components that are involved in ALS, that is, the lower and upper motor neuron. For all neuroimaging modalities, due to the intrinsic heterogeneity of ALS, larger pooled banks of images with standardized image acquisition and analysis procedures are needed. In this paper, we will review the main findings obtained with MRI, PET, SPECT, and nuclear magnetic resonance spectroscopy in ALS.
神经影像学能够用于研究肌萎缩侧索硬化症（ALS）中神经系统退化的程度。先进的磁共振成像（MRI）方法可以检测与上运动神经元退化相关的变化，但也已证实其他系统（如感觉系统或基底神经节）也参与其中，这在活体中证明了ALS是一种多系统疾病。结构和功能成像还能够研究与认知症状相关的脑区功能障碍。从生物标志物的角度来看，众多使用扩散张量成像的研究表明皮质脊髓束颅内部分的分数各向异性降低，但其在个体水平的诊断价值仍然有限。在ALS的诊断检查中使用MRI需要采用多参数方法。一个有前景的途径是脊髓成像的新方法学发展，其优势在于能够研究参与ALS的两个运动系统组成部分，即下运动神经元和上运动神经元。对于所有神经影像学模态而言，由于ALS固有的异质性，需要更大规模的、具有标准化图像采集和分析程序的图像库。在本文中，我们将综述在ALS中通过MRI、正电子发射断层扫描（PET）、单光子发射计算机断层扫描（SPECT）和核磁共振波谱学获得的主要研究结果。
