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ORIGINAL RESEARCH article

Front. Neuroimaging
Sec. Brain Imaging Methods
Volume 4 - 2025 | doi: 10.3389/fnimg.2025.1549727
This article is part of the Research Topic Innovative imaging in neurological disorders: bridging engineering and medicine View all articles

T1-relaxation times along the corticospinal tract as a diagnostic marker in patients with amyotrophic lateral sclerosis

Provisionally accepted
Fiona Dierksen Fiona Dierksen 1*Johanna S Geibel Johanna S Geibel 1Janika Albrecht Janika Albrecht 1Sabine Hofer Sabine Hofer 1Peter Dechent Peter Dechent 2Amelie C Hesse Amelie C Hesse 3Jens Frahm Jens Frahm 4Mathias Bahr Mathias Bahr 1Jan Christoph Koch Jan Christoph Koch 1Jan Liman Jan Liman 5Ilko L Maier Ilko L Maier 1
  • 1 Department of Neurology, University Medical Center Göttingen, Goettingen, Lower Saxony, Germany
  • 2 Department of Cognitive Neurology, University Medical Center Göttingen, Göttingen, Germany
  • 3 Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
  • 4 Biomedical NMR, Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany
  • 5 Department of Neurology, Klinikum Nürnberg, Nürnberg, Germany

The final, formatted version of the article will be published soon.

    In the differential diagnostic workup of amyotrophic lateral sclerosis (ALS), magnetic resonance imaging (MRI) is primarily used to rule out significant differential diagnoses. So far, whole-brain T1-mapping has not been assessed as a diagnostic tool in this patient population.We investigated the diagnostic potential of a novel T1-mapping method based on real-time MRI with 0.5 mm in-plane resolution and 4s acquisition time per slice. The study included patients aged 18 to 90 years who met the revised El Escorial criteria for at least possible ALS. T1-relaxation times were measured along the corticospinal tract in predefined regions of interest.Twenty-nine ALS-patients and 43 control group patients (CG) were included in the study.Median ALS Functional Rating Scale revised (ALSFRS-R) was 37 (IQR, 35-44) points and the mean duration from symptom onset to MRI was 21±17 (SD) months. ALS patients showed significantly higher T1-relaxation times in all ROIs compared to CG with mean differences in the hand knob of 50ms (p<0.001), corona radiata 24ms (p=0.034), internal capsule 27ms (p=0.002) and midbrain peduncles 48ms (p<0.001). There was a consistent negative correlation between the ALSFRS-R and T1-relaxation times in all ROIs.T1-relaxation times along the corticospinal tract are significantly elevated in ALS patients compared to CG and associated with lower ALSFRS-R. These results imply the analysis of T1-relaxation times as a promising diagnostic tool that can distinguish ALS patients from the control group. Ongoing longitudinal studies may provide deeper insights into disease progression and the effects of therapeutic interventions.

    Keywords: T1-mapping, T1 relaxometry, T1-relaxation time, Amyotrophic Lateral Sclerosis, Real-time MRI, corticospinal tract

    Received: 21 Dec 2024; Accepted: 28 Jan 2025.

    Copyright: © 2025 Dierksen, Geibel, Albrecht, Hofer, Dechent, Hesse, Frahm, Bahr, Koch, Liman and Maier. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Fiona Dierksen, Department of Neurology, University Medical Center Göttingen, Goettingen, 37075, Lower Saxony, Germany

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