Exposing asymmetric gray matter vulnerability in amyotrophic lateral sclerosis

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Devine, Matthew; Pannek, Kerstin; Coulthard, Alan; McCombe, Pam; Henderson, Robert; Rose, Stephen


2015-12-31


Journal Article


NeuroImage: Clinical


7


782-787


Limbweakness in amyotrophic lateral sclerosis (ALS) is typically asymmetric. Previous studies have identified an effect of limb dominance on onset and spread of weakness, however relative atrophy of dominant and nondominant brain regions has not been investigated. Our objective was to use voxel-based morphometry (VBM) to explore graymatter (GM) asymmetry in ALS, in the context of limb dominance. 30 ALS subjectswerematched with 17 healthy controls. All subjectswere right-handed. Each underwent a structuralMRI sequence, fromwhich GMsegmentations were generated. Patterns of GMatrophy were assessed in ALS subjects with first weakness in a right-sided limb(n=15) or left-sided limb(n=15).Within each group, a voxelwise comparisonwas also performed between native and mirror GM images, to identify regions of hemispheric GMasymmetry. Subjects with ALS showed disproportionate atrophy of the dominant (left)motor cortex hand area, irrespective of the side of first limb weakness (p b 0.01). Asymmetric atrophy of the left somatosensory cortex and temporal gyri was only observed in ALS subjectswith right-sided onset of limbweakness. Our VBMprotocol, contrasting native andmirror images, was able to more sensitively detect asymmetric GM pathology in a small cohort, compared with standard methods. These findings indicate particular vulnerability of dominant upper limb representation in ALS, supporting previous clinical studies, and with implications for cortical organisation and selective vulnerability.


Elsevier


Neurology and Neuromuscular Diseases


EP156009


Journal article - Refereed


English


Devine, Matthew; Pannek, Kerstin; Coulthard, Alan; McCombe, Pam; Henderson, Robert; Rose, Stephen. Exposing asymmetric gray matter vulnerability in amyotrophic lateral sclerosis. NeuroImage: Clinical. 2015; 7:782-787.



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