J Clin Neurol.  2014 Jul;10(3):249-256. 10.3988/jcn.2014.10.3.249.

Diffusion Tensor Tractography Analysis of the Corpus Callosum Fibers in Amyotrophic Lateral Sclerosis

• Kim JE
• Oh JS
• Sung JJ
• Lee KW
• Song IC
• Hong YH

• KMID: 2179453
• DOI: http://doi.org/10.3988/jcn.2014.10.3.249

Abstract

BACKGROUND AND PURPOSE
Involvement of the corpus callosum (CC) is reported to be a consistent feature of amyotrophic lateral sclerosis (ALS). We examined the CC pathology using diffusion tensor tractography analysis to identify precisely which fiber bundles are involved in ALS.
METHODS
Diffusion tensor imaging was performed in 14 sporadic ALS patients and 16 age-matched healthy controls. Whole brain tractography was performed using the multiple-region of interest (ROI) approach, and CC fiber bundles were extracted in two ways based on functional and structural relevance: (i) cortical ROI selection based on Brodmann areas (BAs), and (ii) the sulcal-gyral pattern of cortical gray matter using FreeSurfer software, respectively.
RESULTS
The mean fractional anisotropy (FA) values of the CC fibers interconnecting the primary motor (BA4), supplementary motor (BA6), and dorsolateral prefrontal cortex (BA9/46) were significantly lower in ALS patients than in controls, whereas those of the primary sensory cortex (BA1, BA2, BA3), Broca's area (BA44/45), and the orbitofrontal cortex (BA11/47) did not differ significantly between the two groups. The FreeSurfer ROI approach revealed a very similar pattern of abnormalities. In addition, a significant correlation was found between the mean FA value of the CC fibers interconnecting the primary motor area and disease severity, as assessed using the revised Amyotrophic Lateral Sclerosis Functional Rating Scale, and the clinical extent of upper motor neuron signs.
CONCLUSIONS
Our findings suggest that there is some degree of selectivity or a gradient in the CC pathology in ALS. The CC fibers interconnecting the primary motor and dorsolateral prefrontal cortices may be preferentially involved in ALS.

Keyword

amyotrophic lateral sclerosis; motor neuron disease; corpus callosum; diffusion tensor imaging; tractography; cortical parcellation

MeSH Terms

Amyotrophic Lateral Sclerosis*
Anisotropy
Brain
Corpus Callosum*
Diffusion Tensor Imaging
Diffusion*
Humans
Motor Neuron Disease
Motor Neurons
Pathology
Prefrontal Cortex

Figure

• 

  Fig. 1 A: Whole brain seeding-based diffusion tensor tractography of the fibers passing through the midsagittal corpus callosum (CC; top, lateral, and anterior views presented in order). The CC fibers were extracted according to their connection to a specific cortical region in the bilateral hemispheres. B: The target region of interest (ROI) was selected based on Brodmann areas (BAs; upper panel) and on the sulcal-gyral pattern of the cortex using FreeSurfer software (lower panel). C: Midsagittal CC maps of the CC fibers from a single subject. The CC fibers (diameter of 0.2 mm) passing through the midsagittal CC are mapped with different colors, which represent selected cortical regions. Atlases of BAs and FreeSurfer ROIs were adapted from http://en.wikipedia.org/wiki/Brodmann_area and the aparc+aseg segmentation in FreeSurfer software. DLPFC: dorsolateral prefrontal cortex, MFC: middle frontal cortex, OFC: orbitofrontal cortex, PMC: primary motor cortex, PostC: postcentral gyrus, PreC: precentral gyrus, PSC: primary sensory cortex, SFC: superior frontal cortex, SMA: supplementary motor area, VFC: ventral frontal cortex.

• 

  Fig. 2 A-D: Correlations between the mean fractional anisotropy (FA) values of the corpus callosum (CC) fibers interconnecting the primary motor cortex (A and C) and precentral gyri (B and D), and disease severity as measured using the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) (r=0.50 and p=0.006 in A, r=0.42 and p=0.02 in B), and the clinical extent of upper motor neuron (UMN) signs (r=-0.42 and p=0.02 in C, r=-0.42 and p=0.022 in D). BA: Brodmann area.

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