Finding Markers in Amyotrophic Lateral Sclerosis Diagnosis

Abstract

Amyotrophic Lateral Sclerosis (ALS) is an uncommon illness, it is caused by moto neuron degeneration, upper, lower and bulbar muscles are affected. Some research also report degeneration in no motor structures of the brain. We proposed to evaluate Electrophysiological and Image techniques like markers in ALS diagnosis and correlate these results. During January 2015 to January 2017, twenty patients with ALS diagnosis and twenty health subjects were evaluated. Sensory and by motor nerve conduction studies, Electromyography, Somato- Sensory Evoked Potentials were done to the patients. 3T MRI image were obtained from the patients and from the health subjects. Post processing MRI techniques like voxel based morphometric, diffusion techniques and corticospinal tract and corpus callosum tractography were applied at different levels of the brain structures. Nerve conduction study was positive in 90% of the patients, SSEP were positive in 60% and EMG abnormalities were observed in 100% of patients. Anatomic MRI was positive in 50% of the patients. Fractional Anisotropy was reduced in ALS group in comparison with health group, more significant at cortex, internal capsule and corpus callosum. Fibers number of cortico-spinal tract and corpus callosum were diminished in ALS group in relation to health group. Also grey and white matter were reduce in ALS group, in areas such as: cingulate gyrus, anterior portion of occipital lobe, left caudate and putamen nucleus, right claustrum nucleus, lower and medium temporal gyrus bilateral, left precentral and post-central gyrus, corpus callosum, corticospinal tract, bilateral internal capsule, bilateral optical radiation, bilateral lower longitudinal fascicle, bilateral hippocampal fimbriae, bilateral radiated corona and pontocerebellar fibers. Electrophysiological studies confirmed ALS diagnosis in 100% of cases. MRI methods show abnormalities in motor and not motor structures of brain in ALS patients. They could be markers in early ALS diagnostic.