Federica Agosta1, Elisabetta Pagani1, Melissa Petrolini1, Maria Pia Sormani2, Domenico Caputo3, Michele Perini4, Alessandro Prelle5, Fabrizio Salvi6, Massimo Filippi1
1Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Scientific Institute and University Hospital San Raffaele, Milan, Italy; 2Unit of Biostatistics, DISSAL, University of Genoa, Genoa, Italy; 3Department of Neurology, Scientific Institute Fondazione Don Gnocchi, Milan, Italy; 4Department of Neurology, Ospedale di Gallarate, Gallarate, Italy; 5Dino Ferrari Center, Department of Neuroscience, University of Milan, Milan, Italy; 6Department of Neurology, Ospedale di Bellaria, University of Bologna, Bologna, Italy
We investigated whether corticospinal tract (CST) DT-MRI changes contribute to the prediction of long-term clinical evolution in patients with amyotrophic laterals sclerosis (ALS). Conventional and DT-MRI were obtained in 24 ALS patients, who were followed prospectively for 3.4 years. Compared with controls, ALS patients showed increased MD and decreased FA of the CST. Shorter disease duration and lower CST FA were associated with disability worsening. Bulbar-onset and CST FA were independent predictors of time to death in ALS patients. More severe DT-MRI abnormalities in the CST predicted a poorer clinical outcome after a 3.4 year follow up in ALS patients.