Neuroimaging in Amyotrophic Lateral Sclerosis

Abstract

The catastrophic system failure in amyotrophic lateral sclerosis is characterized by progressive neurodegeneration within the corticospinal tracts, brainstem nuclei and spinal cord anterior horns, with an extra-motor pathology that has overlap with frontotemporal dementia. The development of computed tomography and, even more so, MRI has brought insights into neurological disease, previously only available through post-mortem study. Although largely research-based, radionuclide imaging has continued to provide mechanistic insights into neurodegenerative disorders. The evolution of MRI to use advanced sequences highly sensitive to cortical and white matter structure, parenchymal metabolites and blood flow, many of which are now applicable to the spinal cord as well as the brain, make it a uniquely valuable tool for the study of a multisystem disorder such as amyotrophic lateral sclerosis. This comprehensive review considers the full range of neuroimaging techniques applied to amyotrophic lateral sclerosis over the last 25 years, the biomarkers they have revealed and future developments.

KEYWORDS::

• diffusion tensor imaging
• functional imaging
• magnetic resonance spectroscopy
• morphometry
• motor neuron disease
• MRI
• PET
• resting state

Financial & competing interests disclosure

MR Turner is funded through the Medical Research Council & Motor Neuron Disease Association Lady Edith Wolfson Clinician Scientist Fellowship (G0701923). V Govind is an NIH funding recipient (R01 NS060874). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

MR Turner is funded through the Medical Research Council & Motor Neuron Disease Association Lady Edith Wolfson Clinician Scientist Fellowship (G0701923). V Govind is an NIH funding recipient (R01 NS060874). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.