A Study On The Swallowing Function And Diffusion Tensor Imaging Of Amyotrophic Lateral Sclerosis

Objective:Preliminary study the inspection application value of videofluoroscopic swallowing study in amyotrophic lateral sclerosis (ALS) and investigate the value of diffusion tensor imaging (DTI) for the diagnosis of amyotrophic lateral sclerosis (ALS)..Methods:Selecting 17 cases of ALS patients with different diagnostic levels, including clinically definite (10 cases), clinically probably (4 cases), clinically possibly (3 cases), videofluoroscopic swallowing study were performed and the correlations between the results of videofluoroscopic swallowing study and various clinical variables were investigated by Pearson correlation analysis. Selecting 54 cases of ALS patients with different diagnostic levels, including clinically definite (21 cases), clinically probably (22 cases), clinically possibly (11 cases). At the same time, selecting 23 healthy volunteers served as controls. Fractional anisotropy (FA) and average diffusion coefficient (ADC) values were measured respectively of each region of interest. The difference diffusion parameters between the two groups were analysised and the correlations between diffusion parameters and various clinical variables were investigated by Pearson correlation analysis.Results:The results of videofluoroscopic swallowing study correlated positively with body mass index (r=0.031, P< 0.05). Compared with healthy controls, a significant increase in ADC were found (P<0.05) on the level of posterior limb of internal capsule and the cerebral peduncle in ALS group. A significant reduction in FA were found (P<0.05) on all the levels of region of interest in ALS group. The ADC values in the posterior limb of internal capsule level correlated negatively with diagnostic levels of the patients (r=-0.289, P <0.05), and correlated positively with upper motor neuron injury score (r=0.304, P<0.05). The FA values in the cerebral peduncle level and posterior limb of internal capsule level correlated positively with the diagnostic levels (r=0.394, P<0.05; r=0.547, P<0.0001), and correlated negatively with upper motor neuron injury score (r=-0.301, P< 0.05; r=-0.653, P<0.0001). Remaining ADC, FA values were not correlated clinical data.Conclusion:videofluoroscopic swallowing study can objectively find the dysphagia of ALS patients, videofluoroscopic swallowing study has an important role in assessing the swallowing function of ALS patients. DTI can objectively evaluate the impairment of pyramidal tracts in ALS patients and can be used as an important adjuvant measure for the diagnosis of ALS.