Evaluation of the relationship between clinical findings and F responses and diffusion tensor tractography in patients with amyotrophic lateral sclerosis

Authors : Pınar BEKDİK, Tuba CERRAHOĞLU ŞİRİN, Serdar ARSLAN, Nurten UZUN ADATEPE

Pages : 208-215

Doi:10.17826/cumj.1228302

View : 15 | Download : 7

Publication Date : 2023-03-31

Article Type : Research Paper

Abstract :Purpose: The aim of this study is to show whether radiologically diffusion tractography imaging insert ignore into journalissuearticles values(DTI); and electrophysiologically F responses methods support clinical examination in Amyotrophic Lateral Sclerosis insert ignore into journalissuearticles values(ALS);. It is to determine the relationships between these two methods. Materials and Methods: Patients with a definite diagnosis of ALS according to the Revised-El Escorial and Awaji criteria at any stage of the disease, who applied to the Electromyography insert ignore into journalissuearticles values(EMG); laboratory of the Neurology Clinic of Istanbul University Cerrahpaşa, Cerrahpaşa Medical Faculty, prospectively and cross-sectionally, were included in the study. The revised ALS functional rating scale insert ignore into journalissuearticles values(ALSFRS-R); was scored. Electrophysiological studies included routine nerve conduction studies, F responses and needle EMG. In radiological examinations, diffusion tractography imaging insert ignore into journalissuearticles values(DTI); maps were obtained in brain and cervical Magnetic Resonance Imaging insert ignore into journalissuearticles values(MRI); and diffusivity and fractional anisotropy insert ignore into journalissuearticles values(FA); values were compared. Results: The mean age of the 12 volunteer patients included in the study was 55.92±9.68 insert ignore into journalissuearticles values(43-72);, and consisted of 4 female and 8 male individuals. The mean ALSFRS-R score was 35.75±7.86 insert ignore into journalissuearticles values(24-46);. MRI was performed in 11 of the patients, spinal imaging could not be performed in one patient. The mean age of the 11 patients who were imaging was 56.4±9.8 years and the disease duration was 2.7±1.9 years. Low values of DTI-FA were found to be associated with poor respiratory and speech scores as assessed by linear regression analysis. Repeater F responses in the ulnar nerves were also associated with a high ALSFRS-R score. Conclusion: In our study, we observed that low values of DTI-FA were associated with poor respiratory and speech scores. Showing the correlation of low FA with a vital function such as respiration may indicate that this technique will be helpful in the prognosis and progression of the disease. The increase of repeater F responses in the ulnar nerves in those with high ALSFRS-R scores suggests that it is worth investigating whether ALS can be used in differentiating from other anterior horn diseases. The results of this study suggest that DTI-FA, which is an advanced radiological evaluation, and repeater F responses as an electrophysiological method may support early diagnosis in ALS.
Keywords : Amiyotrofik Lateral Skleroz, F yanıtı, Difüzyon Tensor Görüntüleme, Fraksiyonel Anizotropi