In this study, we used graph theory and connectomics to test whether the spatial patterning of structural brain alterations in amyotrophic lateral sclerosis (ALS) is modulated by the topology of the anatomical brain network. In the healthy subject connectome, brain regions of subsequent stages of ALS pathology are shown to be more closely interconnected (shorter topological distance) with the primary motor cortex (ALS epicenter) than regions of more distant stages. Altered structural connectivity was greater between closely connected regions. Axonal connections may influence the spatial spreading of pathology in ALS.
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