Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China.
Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China.
CNS Neurosci Ther. 2023 Nov;29(11):3406-3415. doi: 10.1111/cns.14270. Epub 2023 May 19.
To investigate microstructural impairments of corticospinal tracts (CSTs) with different origins in amyotrophic lateral sclerosis (ALS) using neurite orientation dispersion and density imaging (NODDI).
Diffusion-weighted imaging data acquired from 39 patients with ALS and 50 controls were used to estimate NODDI and diffusion tensor imaging (DTI) models. Fine maps of CST subfibers originating from the primary motor area (M1), premotor cortex, primary sensory area, and supplementary motor area (SMA) were segmented. NODDI metrics (neurite density index [NDI] and orientation dispersion index [ODI]) and DTI metrics (fractional anisotropy [FA] and mean/axial/radial diffusivity [MD/AD/RD]) were computed.
The patients with ALS showed microstructural impairments (reflected by NDI, ODI, and FA reductions and MD, AD, and RD increases) in CST subfibers, especially in M1 fibers, which correlated with disease severity. Compared with other diffusion metrics, NDI yielded a higher effect size and detected the greatest extent of CST subfibers damage. Logistic regression analyses based on NDI in M1 subfiber yielded the best diagnostic performance compared with other subfibers and the whole CST.
Microstructural impairment of CST subfibers (especially those originating from M1) is the key feature of ALS. The combination of NODDI and CST subfibers analysis may improve diagnosing performance for ALS.
利用神经丝取向分散和密度成像（NODDI）研究肌萎缩侧索硬化症（ALS）中不同起源的皮质脊髓束（CST）的微观结构损伤。
使用来自 39 名 ALS 患者和 50 名对照者的扩散加权成像数据来估计 NODDI 和弥散张量成像（DTI）模型。对源自初级运动区（M1）、运动前皮质、初级感觉区和辅助运动区（SMA）的 CST 亚纤维进行精细图谱分割。计算 NODDI 指标（神经丝密度指数[NDI]和取向分散指数[ODI]）和 DTI 指标（各向异性分数[FA]和平均/轴向/径向扩散系数[MD/AD/RD]）。
ALS 患者的 CST 亚纤维出现微观结构损伤（表现为 NDI、ODI 和 FA 降低以及 MD、AD 和 RD 增加），尤其是 M1 纤维，与疾病严重程度相关。与其他扩散指标相比，NDI 具有更高的效应量，并且检测到 CST 亚纤维损伤的最大程度。基于 M1 亚纤维 NDI 的逻辑回归分析与其他亚纤维和整个 CST 相比，具有最佳的诊断性能。
CST 亚纤维（尤其是源自 M1 的亚纤维）的微观结构损伤是 ALS 的关键特征。NODDI 与 CST 亚纤维分析的结合可能会提高 ALS 的诊断性能。
