Magnetic resonance findings in amyotrophic lateral sclerosis using a spin echo magnetization transfer sequence: preliminary report

Rocha, Antônio José da; Maia, Antônio Carlos Martins; Nogueira, Roberto Gomes; Lederman, Henrique Manoel

doi:10.1590/s0004-282x1999000600002

Cited by 13 publications

(8 citation statements)

References 7 publications

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“…We consider the centrum semiovale and the precentral subcortical and cortical regions as the best locations to look for CST involvement, because they represent the largest transverse section of the CST in the central nervous system. Some authors demonstrated the value of the T1 SE/MTC sequence to detect CST involvement in ALS patients with high specificity and no false‐positive results 18, 19. Similar results were observed in our MSA patients.…”

Section: Discussionmentioning

confidence: 99%

“…In several neurological conditions, the magnetization transfer ratio (MTR) may indicate the presence of structural changes in encephalic tissue, even when signal intensity changes are absent on conventional sequences 16, 17. The T1 spin‐echo with an additional magnetization transfer contrast pulse (T1 SE/MTC) sequence is sensitive and accurate in depicting corticospinal tract (CST) degeneration in amyotrophic lateral sclerosis (ALS), whereas FLAIR imaging was not 18, 19…”

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confidence: 99%

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Pyramidal tract degeneration in multiple system atrophy: The relevance of magnetization transfer imaging

et al. 2006

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The clinical features of multiple system atrophy (MSA) include four domains: autonomic failure/urinary dysfunction, Parkinsonism, cerebellar ataxia, and corticospinal tract dysfunction. Although the diagnosis of definite MSA requires pathological confirmation, magnetic resonance imaging (MRI) studies have been shown to contribute to the diagnosis of MSA. Although pyramidal tract dysfunction is frequent in MSA patients, signs of pyramidal tract involvement are controversially demonstrated by MRI. We evaluated the pyramidal involvement in 10 patients (7 women) with clinically probable MSA, detecting the presence of spasticity, hyperreflexia, and Babinski sign, as well as demonstrating degeneration of the pyramidal tract and primary motor cortex by MRI in all of them. Our article also discusses key radiological features of this syndrome. In MSA, pyramidal tract involvement seems to be more frequent than previously thought, and the clinicoradiological correlation between pyramidal tract dysfunction and degeneration may contribute to the understanding of the clinical hallmarks of MSA. MRI may also add information regarding the differential diagnosis of this syndrome.

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Section: Discussionmentioning

confidence: 99%

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Pyramidal tract degeneration in multiple system atrophy: The relevance of magnetization transfer imaging

et al. 2006

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“…In the search for the diagnostic test, several imaging modalities have been used with varying success: specifically, diffusion tensor imaging (DTI),17–23 magnetization transfer imaging (MTI),24–27 and proton magnetic resonance spectroscopy ( 1 H‐MRS) 23,28–31. In the following sections, we review the current recognized roles of conventional magnetic resonance imaging (MRI), DTI, MTI, and 1 H‐MRS in the diagnosis of ALS and PLS.…”

Section: Diagnosis Of Umn Involvementmentioning

confidence: 99%

Amyotrophic Lateral Sclerosis and Primary Lateral Sclerosis: The Role of Diffusion Tensor Imaging and Other Advanced MR‐Based Techniques as Objective Upper Motor Neuron Markers

Wang

Melhem

2005

Annals of the New York Academy of Sciences

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Amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease, is a motor neuron disease characterized by progressive degeneration of upper motor neuron (UMN) and lower motor neuron (LMN), while primary lateral sclerosis (PLS) is defined by pure UMN involvement. A reliable objective marker of UMN involvement is critical for the early diagnosis and monitoring of disease progression in patients with ALS and PLS. Diffusion tensor imaging (DTI), magnetization transfer imaging (MTI), and magnetic resonance spectroscopy (MRS), which provide insight into the pathophysiological process of ALS and PLS, show great promise in this regard. Further investigation is needed to determine and to compare the utility of various neuroimaging markers.

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“…The findings of a bilateral symmetrical hyper intensity of the pyramidal tract are suggestive of Als denoting degeneration of corticospinal tracts 11,12 . considering the clinical and laboratory findings, the motor neuron diseases have been classified as Als / DNM (sporadic cases, family or genetically determined), Alsplus syndromes (multisystem neurodegenerative disease affecting motor neurons), the Als -related syndromes (represent symptomatic or secondary forms of motor neuron disease, with a known associated condition that may be causing the disease) and the Als -variants (are uncommon unless the patient lives in particular geographic locations) ( Table 9) 13,14 .…”

Section: Diagnosismentioning

confidence: 97%

Amyotrophic lateral sclerosis (ALS): three letters that change the people's life. For ever

Oliveira

Pereira

2009

Arq. Neuro-Psiquiatr.

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-Amyotrophic lateral sclerosis (Als) is a neurodegenerative disease affecting the motor nervous system. it causes progressive and cumulative physical disabilities in patients, and leads to eventual death due to respiratory muscle failure. The disease is diverse in its presentation, course, and progression. We do not yet fully understand the cause or causes of the disease, nor the mechanisms for its progression; thus, we lack effective means for treating this disease. currently, we rely on a multidisciplinary approach to symptomatically manage and care for patients who have Als. Although amyotrophic lateral sclerosis and its variants are readily recognized by neurologists, about 10% of patients are misdiagnosed, and delays in diagnosis are common. prompt diagnosis, sensitive communication of the diagnosis, the involvement of the patient and their family, and a positive care plan are prerequisites for good clinical management. A multidisciplinary, palliative approach can prolong survival and maintain quality of life. Treatment with riluzole improves survival but has a marginal effect on the rate of functional deterioration, whereas non-invasive ventilation prolongs survival and improves or maintains quality of life. in this review, we discuss the diagnosis, management, and how to cope with impaired function and end of life on the basis of our experience, the opinions of experts, existing guidelines, and clinical trials. Multiple problems require a multidisciplinary approach including aggressive symptomatic management, rehabilitation to maintain motor function, nutritional support (enteric feeding, gastrostomy), respiratory support (non invasive home ventilation, invasive ventilation, tracheotomy), augmentative communication devices, palliative care, psychological support for both patients and families (because family members so often play a central role in management and care), communication between the care team, the patient and his or her family, and recognition of the clinical and social effects of cognitive impairment. social, bioethical, and financial issues as well as advance directives should be addressed. A plethora of evidence-based guidelines should be compiled into an internationally agreed guideline of best practice. The multidisciplinary team has changed the history of disease, with still no curative therapy available.KeY WorDs: amyotrophic lateral sclerosis, diagnosis, treatment.Esclerose lateral amiotrófica (ELA): três letras que mudam a vida de uma pessoa. Para sempre.Resumo -A esclerose lateral amiotrófica (elA) é doença neurodegenerativa comprometendo o sistema nervoso motor. ela causa comprometimento físico, progressivo e acumulativo, com óbito freqüentemente decorrente de falência respiratória. A enfermidade apresenta características diversas nas formas de apresentação, curso e progressão. Não entendemos ainda a causa ou causas dessa enfermidade, nem os mecanismos que regem a sua progressão; assim, tratamentos efetivos não são, até o momento, conhecidos. Atualmente, recomenda-se que os...

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Magnetic resonance findings in amyotrophic lateral sclerosis using a spin echo magnetization transfer sequence: preliminary report

Cited by 13 publications

References 7 publications

Pyramidal tract degeneration in multiple system atrophy: The relevance of magnetization transfer imaging

Pyramidal tract degeneration in multiple system atrophy: The relevance of magnetization transfer imaging

Amyotrophic Lateral Sclerosis and Primary Lateral Sclerosis: The Role of Diffusion Tensor Imaging and Other Advanced MR‐Based Techniques as Objective Upper Motor Neuron Markers

Amyotrophic lateral sclerosis (ALS): three letters that change the people's life. For ever

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