Signs of MRI affection of brain in сlassical Amyotrophic Lateral Sclerosis patients

Abstract

T2 hyperintensive focal lesions were found on brain MRI only in 41 patients (9.7 %) from the ALS group (n = 423). Female were 20 (48,8 %) and male - 21 (51,2 %), aged 31 to 78 years (middle age is 56 ± 4). Focal MRI lesions were found exclusively in projection of the intracranial section of the corticospinal tract. They were always bilateral and symmetrical and were located at one or two levels, most often in the posterior limb of internal capsule and in cerebral peduncle (85 % and 60 % correspondingly). They were less frequent in the radiate crown, semioval center or medulla. There was no reliable correlation between MRI changes and clinical type of ALS, age of disease onset, duration of symptoms and region of onset of muscle weakness and atrophy. Foci of hyperintensive MRI signal in the ALS did not change in terms of time and space, and did not accumulate contrast media with disease progression. This prevents from using routine T1 and T2 mode MRI for monitoring the course of the disease, its prognosis and treatment efficiency. We can recommend cerebral MRI for early diagnostics of ALS and also to rule out other diseases which may resemble ALS. However diagnostic value of 1.5 Tesla MRI is quite limited for diagnostics of classic ALS and its subtypes (PLS and PBP).