Article Figures & Data
Figures
- Fig 1.
Correlations between performances at the TMT (part A, part B, and difference between performance times of part B and part A) and FA of the corpus callosum, corticospinal tract, right inferior longitudinal fasciculus, and left inferior fronto-occipital fasciculus in patients with ALS. For illustrative purpose, the left column shows the reconstructions of the WM tracts in a single healthy control (tracts are superimposed onto the mean FA image). The right columns show the scatterplots of the correlations; FA values are reported on the x-axis (β, regression coefficient; partial R2, proportion of variability accounted for by the given DT MR imaging variable); PFDR, P values adjusted for multiple comparisons controlling for the false discovery rate.
Tables
Healthy Controls ALS Patients Pa N 15 16 Age (yr) 63 ± 12 (43–77) 61 ± 10 (40–74) 0.47 Women (%) 8 (53) 8 (50) 0.85 Education (yr) 12 ± 6 (5–24) 9 ± 4 (5–17) 0.18 Disease duration (mo) 29 ± 19 (3–84) ALSFR-R score 33 ± 7 (22–44) UL-MRC score 54 ± 11 (39–68) LL-MRC score 33 ± 15 (2–48) UMN score 13 ± 4 (3–16) Note:—Values are means ± SD (range) or N (percentages); UL-MRC indicates Upper Limb-Medical Research Council; LL-MRC, Lower Limb-Medical Research Council.
↵a Pearson χ2 test or the Mann-Whitney U test, as appropriate.
Mean ± SD (Range) N of Patients with an Abnormal Performance (%) General cognition MMSE (cutoff, 24) 28.0 ± 2.0 (24–30) 0 Verbal learning Rey's words, immediate recall (cutoff, 28.53) 43 ± 12 (18–60) 0 Verbal memory Rey's words, delayed recall (cutoff, 4.69) 10 ± 3 (5–15) 0 Spatial memory Rey's figure recall (cutoff, 9.47) 15 ± 7 (8–29) 2 (12.5) Attention and executive functions TMT-A (cutoff, 93) 44 ± 49 (5–191) 1 (6) TMT-B (cutoff, 282) 75 ± 70 (4–278) 0 TMT-BA (cutoff, 186) 32 ± 25 (1–88) 0 Stroop test (cutoff, 36.91) 32 ± 18 (11–69) 3 (19) WCST, global score (cutoff, 90.50) 66 ± 29 (20–109) 3 (19) Phonemic fluency (cutoff, 17) 34 ± 12 (14–55) 2 (12.5) Semantic fluency (cutoff, 25) 41 ± 10 (21–59) 1 (6) Visuospatial abilities Rey's figure copy (cutoff, 28.88) 26 ± 6 (17–33) 5 (31) Behavioral functioning NPI, global score 2 ± 4 (0–12) 2 (12.5)a Note:—Scores are corrected for age, gender, and education; MMSE indicates Mini-Mental State Examination; TMT, Trail-Making Test; WCST, Wisconsin Card Sorting Test; NPI, Neuropsychiatric Inventory.
Stroop and TMT test scores are expressed in seconds.
↵a NPI total domain score (severity × frequency) ≥3 on at least 2 domains.
- Table 3:
DT MR imaging metrics of specific WM tracts in patients with ALS and healthy controls
FA MD (× 10−3 mm2 s−1) radD (× 10−3 mm2 s−1) AxD (× 10−3 mm2 s−1) HC ALS HC ALS HC ALS HC ALS CC 0.62 ± 0.03 0.61 ± 0.03 0.76 ± 0.04 0.79 ± 0.05*§ 0.44 ± 0.04 0.47 ± 0.05§ 1.40 ± 0.06 1.44 ± 0.05 CST R 0.67 ± 0.03 0.63 ± 0.04*§# 0.71 ± 0.02 0.75 ± 0.04*§# 0.37 ± 0.02 0.43 ± 0.04**§# 1.37 ± 0.07 1.38 ± 0.05 L 0.67 ± 0.03 0.63 ± 0.03*§# 0.71 ± 0.03 0.76 ± 0.04*§# 0.38 ± 0.02 0.44 ± 0.05**§# 1.37 ± 0.08 1.39 ± 0.05 SLF R 0.49 ± 0.03 0.47 ± 0.03 0.73 ± 0.04 0.77 ± 0.06*§ 0.51 ± 0.04 0.55 ± 0.06* 1.15 ± 0.06 1.20 ± 0.07*§ L 0.49 ± 0.03 0.48 ± 0.03 0.74 ± 0.03 0.77 ± 0.05*§ 0.52 ± 0.04 0.55 ± 0.05*§ 1.18 ± 0.05 1.21 ± 0.06 Cingulum R 0.57 ± 0.04 0.57 ± 0.03 0.73 ± 0.03 0.76 ± 0.05*§ 0.46 ± 0.04 0.49 ± 0.05 1.27 ± 0.06 1.32 ± 0.06* L 0.57 ± 0.04 0.56 ± 0.03 0.75 ± 0.05 0.78 ± 0.05 0.48 ± 0.06 0.50 ± 0.05 1.31 ± 0.06 1.35 ± 0.07 IFOF R 0.55 ± 0.03 0.54 ± 0.03 0.80 ± 0.04 0.82 ± 0.06 0.52 ± 0.05 0.55 ± 0.05 1.34 ± 0.05 1.38 ± 0.80§ L 0.53 ± 0.04 0.52 ± 0.02 0.81 ± 0.05 0.84 ± 0.06 0.54 ± 0.05 0.57 ± 0.05 1.34 ± 0.06 1.39 ± 0.083 ILF R 0.46 ± 0.03 0.45 ± 0.02 0.81 ± 0.05 0.84 ± 0.06 0.60 ± 0.05 0.62 ± 0.05 1.23 ± 0.06 1.27 ± 0.087 L 0.47 ± 0.04 0.46 ± 0.03 0.81 ± 0.06 0.83 ± 0.05 0.58 ± 0.06 0.61 ± 0.05 1.26 ± 0.08 1.27 ± 0.06 Uncinate R 0.43 ± 0.03 0.42 ± 0.03 0.79 ± 0.04 0.83 ± 0.06*§ 0.59 ± 0.04 0.63 ± 0.06*§ 1.20 ± 0.05 1.25 ± 0.07*§ L 0.41 ± 0.03 0.42 ± 0.03 0.82 ± 0.05 0.86 ± 0.06*§ 0.62 ± 0.05 0.65 ± 0.06 1.20 ± 0.07 1.29 ± 0.07*§# Fornix 0.40 ± 0.05 0.40 ± 0.03 1.18 ± 0.23 1.22 ± 0.18 0.93 ± 0.02 0.96 ± 0.02 1.67 ± 0.20 1.73 ± 0.17 Note:—Values are means ± SD; HC indicates healthy controls; radD, radial diffusivity; AxD, axial diffusivity; CC, corpus callosum.
↵* P <0.05 and
↵** P <0.001 in patients with ALS versus HC;
↵§ P < .05 in patients with ALS who scored below the cutoff in at least one cognitive test versus HC, and
↵# P <.05 in patients with ALS with normal cognitive tests versus HC, according to the multivariate linear models adjusted for age (see text for details).
- Table 4:
Regression coefficients, P values, and goodness of fit measures of the relationships of neuropsychologic test scores with WM tract mean diffusivity and FA values, adjusted for subject age and clinical disability
Neuropsychologic Test DT MR Variable β Pa pFDRb Partial R2 Overall R2 TMT-A CC MD 0.008 .03 .13 0.20 0.76 R ILF MD 0.007 .05 .13 0.18 0.74 CC FA −0.013 .01 .04 0.25 0.81 R CST FA −0.016 .02 .04 0.21 0.78 L CST FA −0.016 .02 .04 0.21 0.78 R cingulum FA −0.011 .046 .07 0.18 0.74 R IFOF FA −0.015 .01 .04 0.26 0.83 L IFOF FA −0.020 .003 .02 0.30 0.87 R ILF FA −0.020 .003 .02 0.30 0.86 L ILF FA −0.015 .01 .04 0.24 0.80 R uncinate FA −0.015 .02 .04 0.22 0.78 TMT-B CC MD 0.01 .04 .15 0.23 0.70 CC FA −0.017 .01 .051 0.30 0.77 R cingulum FA −0.014 .047 .07 0.22 0.69 L cingulum FA −0.016 .04 .07 0.23 0.70 R IFOF FA −0.021 .002 .01 0.38 0.85 L IFOF FA −0.029 <.001 .001 0.46 0.93 R ILF FA −0.023 .01 .051 0.29 0.76 R uncinate FA −0.018 .03 .07 0.25 0.72 TMT-BA R IFOF FA −0.029 .01 .09 0.36 0.72 L IFOF FA −0.039 .004 .049 0.43 0.79 Stroop test CC FA −0.014 .03 .22 0.36 0.41 R IFOF FA −0.011 .048 .22 0.32 0.37 R ILF FA −0.018 .02 .22 0.41 0.46 WCST, global score R IFOF MD −0.007 .03 .11 0.31 0.64 L IFOF MD −0.007 .02 .11 0.34 0.67 R ILF MD −0.007 .03 .11 0.32 0.65 L ILF MD −0.008 .02 .11 0.35 0.68 R IFOF FA 0.016 .02 .32 0.46 0.53 Phonemic fluency L cingulum FA 0.008 .01 .20 0.36 0.47 Rey's words, immediate recall Fornix MD −0.001 .04 .32 0.16 0.67 Fornix FA 0.005 .004 .055 0.27 0.77 Rey's words, delayed recall Fornix MD −0.002 .03 .43 0.50 0.62 Rey's figure copy L uncinate FA 0.005 .04 .51 0.32 0.73 Note:—β, regression coefficient; partial R2, proportion of variability accounted for by the given DT MRI variable; overall R2, proportion of variability accounted for by the full statistical model; TMT, Trail-Making Test; WCST, Wisconsin Card Sorting Test; CC, corpos callosum; CST, corticospinal tract.
↵a P values according to the multivariate linear models, adjusting for subject's age and ALSFRS-r.
↵b P values also were adjusted for multiple comparisons controlling the false discovery rate.
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