Ontology highlight
ABSTRACT: Background
MRI studies reported that ALS patients with bulbar and spinal onset showed focal cortical changes in corresponding regions of the motor homunculus. We evaluated the capability of brain 2-[18F]FDG-PET to disclose the metabolic features characterizing patients with pure bulbar or spinal motor impairment.Methods
We classified as pure bulbar (PB) patients with bulbar onset and a normal score in the spinal items of the ALSFRS-R, and as pure spinal (PS) patients with spinal onset and a normal score in the bulbar items at the time of PET. Forty healthy controls (HC) were enrolled. We compared PB and PS, and each patient group with HC. Metabolic clusters showing a statistically significant difference between PB and PS were tested to evaluate their accuracy in discriminating the two groups. We performed a leave-one-out cross-validation (LOOCV) over the entire dataset. Four classifiers were considered: support vector machines (SVM), K-nearest neighbours, linear classifier, and decision tree. Then, we used a separate test set, including 10% of patients, with the remaining 90% composing the training set.Results
We included 63 PB, 271 PS, and 40 HC. PB showed a relative hypometabolism compared to PS in bilateral precentral gyrus in the regions of the motor cortex involved in the control of bulbar function. SVM showed the best performance, resulting in the lowest error rate in both LOOCV (4.19%) and test set (9.09 ± 2.02%).Conclusions
Our data support the concept of the focality of ALS onset and the use of 2-[18F]FDG-PET as a biomarker for precision medicine-oriented clinical trials.
SUBMITTER: Canosa A
PROVIDER: S-EPMC9886651 | biostudies-literature | 2023 Feb
REPOSITORIES: biostudies-literature
Canosa Antonio A Martino Alessio A Giuliani Alessandro A Moglia Cristina C Vasta Rosario R Grassano Maurizio M Palumbo Francesca F Cabras Sara S Di Pede Francesca F De Mattei Filippo F Matteoni Enrico E Polverari Giulia G Manera Umberto U Calvo Andrea A Pagani Marco M Chiò Adriano A
Journal of neurology 20221102 2
<h4>Background</h4>MRI studies reported that ALS patients with bulbar and spinal onset showed focal cortical changes in corresponding regions of the motor homunculus. We evaluated the capability of brain 2-[<sup>18</sup>F]FDG-PET to disclose the metabolic features characterizing patients with pure bulbar or spinal motor impairment.<h4>Methods</h4>We classified as pure bulbar (PB) patients with bulbar onset and a normal score in the spinal items of the ALSFRS-R, and as pure spinal (PS) patients w ...[more]