Gray Matter Volume Changes Over The Whole Brain In Amyotrophic Lateral Sclerosis:a Voxel-based Morphometry Study

Objective Our purpose was to to study the structural changes of the whole brains in patients with amyotrophic lateral sclerosis (ALS).Material and Methods Thirty patients with ALS and 30 the age- and sex-matched control subjects were enrolled in the study. Gray volume differences of the whole brain were assessed using SPM8 to make voxel-based morphometry (VBM) comparison between patients and the control subjects. The model was designed to identify the brain regions attributing to the ALSFRS-R score, disease progression rate and disease duration. In addition, longitudinal analysis was performed in a subset of 14 patients who were able and willing to undergo a follow-up MRI scanning session.Results In our ALS patients, VBM revealed clusters of gray matter (GM) atrophy in the primary motor cortex and in non-primary motor-related areas of frontal and parietal lobes. Additional clusters of GM atrophy were observed in extra-motor cortices, namely temporal lobe and frontal pole (P<.001, uncorrected, k≥703). In ALS, the positive correlation between gray matter value and ALSFRS-R score was found in the area of right premotor (P<.001, uncorrected, k≥75).Conclusion Gray matter reductions in primary motor area observed with VBM in patients with ALS, which is a multisystem disorder, potentially can be as a structural markers to identify an extended motor cortical damage of ALS patients.