Combining structural and metabolic markers in a quantitative MRI study of motor neuron diseases

Antonietta Canna, Francesca Trojsi, Federica Di Nardo, Giuseppina Caiazzo, Gioacchino Tedeschi, Mario Cirillo, Fabrizio Esposito

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Objective: To assess the performance of a combination of three quantitative MRI markers (iron deposition, basal neuronal metabolism, and regional atrophy) for differential diagnosis between amyotrophic lateral sclerosis (ALS) and primary lateral sclerosis (PLS). Methods: In total, 33 ALS, 12 PLS, and 28 healthy control (HC) subjects underwent a 3T MRI study including single- and multi-echo sequences for gray matter (GM) volumetry and quantitative susceptibility mapping (QSM) and a pseudo-continuous arterial spin labeling (ASL) sequence for cerebral blood flow (CBF) measurement. Mean values of QSM, CBF, and GM volumes were extracted in the motor cortex, basal ganglia, thalamus, amygdala, and hippocampus. A generalized linear model was applied to the three measures to binary discriminate between groups. The diagnostic performances were evaluated via receiver operating characteristic analyses. Results: A significant discrimination was obtained: between ALS and HCs in the left and right motor cortex, where QSM increases were respectively associated with disability scores and disease duration; between PLS and ALS in the left motor cortex, where PLS patients resulted significantly more atrophic; between ALS and HC in the right motor cortex, where GM volumes were associated with upper motor neuron scores. Significant discrimination between ALS and HC was achieved in subcortical structures only combining all three parameters. Interpretation: While increased QSM values in the motor cortex of ALS patients is a consolidated finding, combining QSM, CBF, and GM volumetry shows higher diagnostic potential for differentiating ALS patients from HC subjects and, in the motor cortex, between ALS and PLS.

Original languageEnglish (US)
Pages (from-to)1774-1785
Number of pages12
JournalAnnals of Clinical and Translational Neurology
Issue number9
StatePublished - Sep 2021

Bibliographical note

Publisher Copyright:
© 2021 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.


Dive into the research topics of 'Combining structural and metabolic markers in a quantitative MRI study of motor neuron diseases'. Together they form a unique fingerprint.

Cite this