Upper motor neuron involvement in amyotrophic lateral sclerosis evaluated by triple stimulation technique and diffusion tensor MRI

被引:0
作者
Jasna Furtula
Birger Johnsen
Jesper Frandsen
Anders Rodell
Peter Broegger Christensen
Kirsten Pugdahl
Anders Fuglsang-Frederiksen
机构
[1] Aarhus University Hospital,Department of Clinical Neurophysiology
[2] Aarhus University Hospital,Center of Functionally Integrative Neuroscience (CFIN)
[3] Aarhus University Hospital,Department of Nuclear Medicine and PET Center
[4] Aarhus University Hospital,Department of Neurology
来源
Journal of Neurology | 2013年 / 260卷
关键词
Amyotrophic lateral sclerosis; Motor evoked potentials; Diffusion tensor imaging; Triple stimulation technique; Upper motor neuron;
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摘要
The objective of this study was to evaluate the diagnostic value of triple stimulation technique (TST) and diffusion tensor imaging (DTI) tractography as markers of upper motor neuron (UMN) degeneration in amyotrophic lateral sclerosis (ALS). Fourteen ALS patients fulfilling the El Escorial criteria and 30 control subjects participated in the study. TST amplitude and area ratio were used as an estimate of the degree of central motor conduction failure. DTI fractional anisotropy was used as a quantitative measure of the structural integrity of the corticospinal tract and the posterior limb of the internal capsule. Mean TST amplitude and area ratio were lower in patients than controls, while there were no differences in mean fractional anisotropy of the corticospinal tract or the posterior limb of the internal capsule. TST was abnormal in 7/13 patients (sensitivity 54 %) and DTI was abnormal in 3/12 (sensitivity 25 %). Combining TST and DTI disclosed abnormalities in 8/11 patients (sensitivity 73 %). TST confirmed UMN degeneration in one of every 2.25 patient in the diagnostic categories lower than ‘probable’ ALS. Using results from TST as a criterion for UMN degeneration, four patients in diagnostic categories lower than ‘probable’ ALS and without clinical signs of UMN degeneration in the cervical region increased in diagnostic category. Our findings indicate that TST has a significant diagnostic value as an early objective marker of UMN degeneration in ALS, while the value of DTI analysis seems limited.
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页码:1535 / 1544
页数:9
相关论文
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