Verstraete Esther, Foerster Bradley R
Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands.
Neurotherapeutics. 2015 Apr;12(2):403-16. doi: 10.1007/s13311-015-0347-9.
Amyotrophic lateral sclerosis (ALS) is characterized by progressive degeneration of upper and lower motor neurons, with variable involvement of extramotor brain regions. Currently, there are no established objective markers of upper motor neuron and extramotor involvement in ALS. Here, we review the potential diagnostic value of advanced neuroimaging techniques that are increasingly being used to study the brain in ALS. First, we discuss the role of different imaging modalities in our increasing understanding of ALS pathogenesis, and their potential to contribute to objective upper motor neuron biomarkers for the disease. Second, we discuss the challenges to be overcome and the required phases of diagnostic test development to translate imaging technology to clinical care. We also present examples of multidimensional imaging approaches to achieve high levels of diagnostic accuracy. Last, we address the role of neuroimaging in clinical therapeutic trials. Advanced neuroimaging techniques will continue to develop and offer significant opportunities to facilitate the development of new effective treatments for ALS.
肌萎缩侧索硬化症（ALS）的特征是上下运动神经元进行性退化，伴有运动外脑区的不同程度受累。目前，尚无已确立的ALS上运动神经元和运动外受累的客观标志物。在此，我们综述了先进神经成像技术的潜在诊断价值，这些技术正越来越多地用于研究ALS患者的大脑。首先，我们讨论不同成像方式在增进我们对ALS发病机制理解方面的作用，以及它们为该疾病贡献客观上运动神经元生物标志物的潜力。其次，我们讨论在将成像技术转化为临床应用时需要克服的挑战以及诊断测试开发所需的阶段。我们还展示了实现高水平诊断准确性的多维成像方法实例。最后，我们阐述神经成像在临床治疗试验中的作用。先进神经成像技术将持续发展，并为促进开发针对ALS的新的有效治疗方法提供重大机遇。
