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Clinical Article
Value of detecting changes in white matter fiber integrity in patinets with amyotrophic lateral sclerosis based on automatic fiber quantification
XU Rui  ZHU Sijia  WANG Ning  KONG Ying  YU Yixing  JIANG Bin  WAN Jiayi  MA Jiali  FANG Qi  ZHU Mo 

XU R, ZHU S J, WANG N, et al. Value of detecting changes in white matter fiber integrity in patinets with amyotrophic lateral sclerosis based on automatic fiber quantification[J]. Chin J Magn Reson Imaging, 2023, 14(9): 44-49. DOI:10.12015/issn.1674-8034.2023.09.008.

[Abstract] Objective To analyze the changes of white matter fiber integrity in patients with amyotrophic lateral sclerosis (ALS) by automatic fiber quantification (AFQ) technology, and explore the feasibility of combining it with support vector machine (SVM) to identify ALS disease.Materials and Methods Clinical and MRI data of 29 patients with ALS (ALS group) and 29 matched healthy controls (HCs group) were prospectively included. Diffusion tensor imaging (DTI) data from all subjects were analyzed using the AFQ software package, and 20 white matter fiber bundles in the whole brain were tracked. Then each fiber bundle was divided into 100 equal parts to acquire quantitative parameter values such as fraction anisotropy (FA), mean diffusion (MD), radial diffusion (RD) and axial diffusion (AD). Partial correlation was further used to explore the relationships between DTI parameters and clinical indicators. Extracting the classification features with white matter fiber difference between two subjects. SVM was used to distinguish them and estimated the accuracy rate.Results The AFQ results showed that, compared with the HCs, the ALS patients had decreased FA values and AD values in the left corticospinal tract, higher AD values in the left inferior fronto-occipital fasciculus and the right superior longitudinal fasciculus, higher MD and RD values of the bilateral corticospinal tract. The average FA value of the left corticospinal tract was positively correlated with Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) fine functional domain score (r=0.386, P=0.046) and the average AD value of the right superior longitudinal fasciculus was positively correlated with ALSFRS-R bulbar functional domain score (r=0.422, P=0.028). Both the average MD and RD values of the right corticospinal tract were negatively associated with the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) score (r=-0.428, P=0.026; r=-0.416, P=0.031). All the selected nodes with inter-group differences in damaged fiber tracts were used as feature values to achieve a good classification effect. The identification accuracy rate for the ALS and HCs groups was 81.00%, and the maximum area under the curve (AUC) value for the receiver operating characteristic (ROC) was 0.90.Conclusions The white matter microarchitectural damage in ALS is mainly related to the corticospinal tract, and these abnormalities detected by AFQ analysis can be used as a valid biomarker, which can improve the diagnostic evaluation of ALS patients when combined with the SVM method.
[Keywords] amyotrophic lateral sclerosis;diffusion tensor imaging;magnetic resonance imaging;automatic fiber quantification;corticospinal tract;support vector machine

XU Rui1   ZHU Sijia2   WANG Ning1   KONG Ying1   YU Yixing1   JIANG Bin1   WAN Jiayi1   MA Jiali1   FANG Qi2   ZHU Mo1*  

1 Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China

2 Department of Neurology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China

Corresponding author: Zhu M, E-mail:

Conflicts of interest   None.

ACKNOWLEDGMENTS Jiangsu Provincial Health Commission's Elderly Health Project (No. LK2021017).
Received  2023-04-11
Accepted  2023-09-08
DOI: 10.12015/issn.1674-8034.2023.09.008
XU R, ZHU S J, WANG N, et al. Value of detecting changes in white matter fiber integrity in patinets with amyotrophic lateral sclerosis based on automatic fiber quantification[J]. Chin J Magn Reson Imaging, 2023, 14(9): 44-49. DOI:10.12015/issn.1674-8034.2023.09.008.

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