Neurofilament light-chain (NF-L) levels in serum and cerebrospinal fluid (CSF) have recently been demonstrated as robust clinical biomarkers in amyotrophic lateral sclerosis (ALS). Nonetheless, the association between NF-L levels and ALS specific neurodegeneration patterns in the precentral cortex, a primarily affected area, has not been fully divulged. Combining 3T and 7T anatomical imaging with NF-L measures, clinical and electrophysiological data, we demonstrated regional-specific degradation within the precentral cortex according to affected limb areas. Further, NF-L levels negatively correlated with cortical thickness within the premotor cortex, suggesting the premotor cortex may be an important contributor to augmented NF-L levels in ALS.
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