Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China.
Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.
Neuroimage Clin. 2018 Apr 4;19:122-129. doi: 10.1016/j.nicl.2018.04.005. eCollection 2018.
The results of recent diffusion tensor imaging (DTI) studies on amyotrophic lateral sclerosis (ALS) are inconclusive and controversial. We performed a voxel-based meta-analysis to identify a statistical consensus among published DTI studies of altered white matter (WM) microarchitecture in ALS.
A systematic search was conducted for relevant studies that used voxel-wise analyses of WM microarchitecture in patients with ALS. Anisotropic effect size-signed differential mapping (AES-SDM) was applied to analyze fractional anisotropy (FA) differences between ALS patients and healthy controls. Meta-regression analysis was used to explore the effects of clinical characteristics on WM integrity in patients with ALS.
A total of 14 studies with 16 datasets that included 396 patients and 360 healthy controls were identified. The pooled meta-analysis revealed that patients with ALS exhibited significant FA reductions in two clusters relative to healthy controls. The largest cluster exhibited a peak coordinate in the left corona radiata, extending to the body and splenium of the corpus callosum, left superior longitudinal fasciculus, posterior limb of the internal capsule, right corona radiata, and bilateral cingulate gyrus. The other cluster exhibited decreased FA in the right corticospinal tract that extended to the right cerebral peduncle. The Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) score was positively correlated with the FA reduction in the left corona radiata. Mean age and illness duration were not linearly correlated with the FA reductions.
This study provides a thorough profile of WM microarchitecture alterations in patients with ALS and further evidence that the neuronal degeneration is not limited to the corticospinal tract but also includes extra-motor areas, which supports the view that ALS is a multisystem degenerative disorder that involves the white matter.
最近的扩散张量成像（DTI）研究结果对肌萎缩侧索硬化症（ALS）的结论并不一致，存在争议。我们进行了基于体素的荟萃分析，以确定已发表的 ALS 患者白质（WM）微观结构改变的 DTI 研究中的统计共识。
对使用 WM 微观结构基于体素分析的 ALS 患者的相关研究进行了系统搜索。采用各向异性效应大小差异映射（AES-SDM）分析 ALS 患者与健康对照组之间 FA 差异。进行元回归分析，以探讨临床特征对 ALS 患者 WM 完整性的影响。
共纳入了 14 项研究，共 16 个数据集，包含 396 名患者和 360 名健康对照者。汇总的荟萃分析显示，与健康对照组相比，ALS 患者有两个簇的 FA 显著降低。最大的簇在左侧放射冠显示出一个峰值坐标，延伸至胼胝体体部和压部、左侧上纵束、内囊后肢、右侧放射冠和双侧扣带回。另一个簇在右侧皮质脊髓束表现出 FA 降低，延伸至右侧大脑脚。肌萎缩侧索硬化功能评定量表修订版（ALSFRS-R）评分与左侧放射冠 FA 降低呈正相关。平均年龄和疾病持续时间与 FA 降低无线性相关。
本研究提供了 ALS 患者 WM 微观结构改变的详细图谱，进一步证明神经元变性不仅限于皮质脊髓束，还包括运动前区，这支持了 ALS 是一种多系统退行性疾病，涉及白质的观点。
