Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.
Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
Prog Neuropsychopharmacol Biol Psychiatry. 2018 Apr 20;83:110-117. doi: 10.1016/j.pnpbp.2018.01.007. Epub 2018 Jan 9.
Structural neuroimaging studies of white matter (WM) volume in amyotrophic lateral sclerosis (ALS) using voxel-based morphometry (VBM) have yielded inconsistent findings. This study aimed to perform a quantitative voxel-based meta-analysis using effect-size signed differential mapping (ES-SDM) to establish a statistical consensus between published studies for WM volume alterations in ALS. The pooled meta-analysis revealed significant WM volume losses in the bilateral supplementary motor areas (SMAs), bilateral precentral gyri (PGs), left middle cerebellar peduncle and right cerebellum in patients with ALS, involving the corticospinal tract (CST), interhemispheric fibers, subcortical arcuate fibers, projection fibers to the striatum and cortico-ponto-cerebellar tract. The meta-regression showed that the ALS functional rating scale-revised (ALSFRS-R) was positively correlated with decreased WM volume in the bilateral SMAs, whereas illness duration was negatively correlated with WM volume reduction in the right SMA. This study provides a thorough profile of WM volume loss in ALS and robust evidence that ALS is a multisystem neurodegenerative disease that involves a variety of subcortical WM tracts extending beyond motor cortex involvement.
使用基于体素的形态测量学（VBM）对肌萎缩侧索硬化症（ALS）的白质（WM）体积进行的结构神经影像学研究得出的结果不一致。本研究旨在使用效应大小符号差异映射（ES-SDM）进行定量基于体素的荟萃分析，以在发表的研究之间建立关于 ALS 中 WM 体积变化的统计共识。合并荟萃分析显示，在 ALS 患者中双侧辅助运动区（SMA）、双侧中央前回（PG）、左侧小脑中脑脚和右侧小脑的 WM 体积存在明显损失，涉及皮质脊髓束（CST）、半球间纤维、皮质下弓状纤维、向纹状体的投射纤维和皮质桥脑小脑束。Meta 回归显示，肌萎缩侧索硬化功能评定量表修订版（ALSFRS-R）与双侧 SMA 中 WM 体积减少呈正相关，而疾病持续时间与右侧 SMA 中 WM 体积减少呈负相关。本研究全面描述了 ALS 中的 WM 体积损失，并提供了有力证据，证明 ALS 是一种多系统神经退行性疾病，涉及多种皮质下 WM 束，超出了运动皮层受累的范围。
