Heterogeneity of motor phenotypes is a clinically well-recognized fundamental aspect of amyotrophic lateral sclerosis (ALS).The body region of onset is one of independent primary attributes of ALS motor phenotype heterogeneity. In order to investigate the patterns of brain atrophy between ALS patients with bulbar and limb onset and analyse its correlation with clinical characteristics , cortical thickness analyses were performed. ALS Patients with limb onset revealed the majority of significant cortical thinning in the limb segment of the motor cortex, and patients with bulbar onset, in the bulbar segments. The findings suggest that neuroimaging could be a helpful objective measure to estimate of upper motor neuron loss.
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