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Mapping motor and extra-motor gray and white matter changes in ALS: a comprehensive review of MRI insights

Title: Mapping motor and extra-motor gray and white matter changes in ALS: a comprehensive review of MRI insights
Authors: Iuzzolino V. V.; Scaravilli A.; Carignani G.; Senerchia G.; Pontillo G.; Dubbioso R.; Cocozza S.
Contributors: Iuzzolino, V. V.; Scaravilli, A.; Carignani, G.; Senerchia, G.; Pontillo, G.; Dubbioso, R.; Cocozza, S.
Publication Year: 2025
Collection: IRIS Università degli Studi di Napoli Federico II
Subject Terms: Amyotrophic lateral sclerosi; Biomarker; Gray matter; Magnetic resonance imaging; White matter
Description: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease primarily affecting motor neurons, yet with substantial clinical variability. Furthermore, beyond motor symptoms, ALS patients also show non-motor features, reflecting its classification as a multi-system disorder. The identification of reliable biomarkers is a critical challenge for improving diagnosis, tracking disease progression, and predicting patient outcomes. This review explores macro- and microstructural alterations in ALS, focusing on gray matter (GM) and white matter (WM) as observed through Magnetic Resonance Imaging (MRI). This approach synthesizes not only the expected involvement of motor areas but also highlights emerging evidence that these changes extend to extra-motor areas, such as the frontal and temporal lobes, underscoring the complex pathophysiology of ALS. The review emphasizes the potential of MRI as a non-invasive tool to provide new biomarkers by assessing both GM and WM integrity, a key advancement in ALS research. Additionally, it addresses existing discrepancies in findings and stresses the need for standardized imaging protocols. It also highlights the role of multi-modal MRI approaches in deepening our understanding of ALS pathology, emphasizing the importance of combining structural and diffusion MRI techniques to offer more comprehensive insights into ALS progression, ultimately advancing the potential for personalized treatment strategies and improving patient outcomes.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/wos/WOS:001480166800001; journal:NEURORADIOLOGY; https://hdl.handle.net/11588/1005351
DOI: 10.1007/s00234-025-03629-7
Availability: https://hdl.handle.net/11588/1005351; https://doi.org/10.1007/s00234-025-03629-7
Rights: info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.9D434507
Database: BASE