Amyotrophic Lateral Sclerosis (ALS) is a rapidly progressing neurodegenerative disease characterized by the degeneration of the motor system and the loss of motor control. A systematic in-vivo description of the microstructural changes in primary motor cortex (M1) that characterise early-stage ALS, and their subsequent development, is so far lacking.

The group of Esther Kühn combined submillimeter structural 7 Tesla (7T) MRI data, functional localisers of body parts and automated layer modelling to create for the first time layer-specific in vivo pathology maps of M1 in living ALS-patients with reference to age-, gender-, handedness- and education-matched controls. The pathology maps reveal a layer-specific profile of ALS pathology in M1 that relates to the clinical phenotype, and uncover a potential role of low-myelin borders in the disease progress. 

They also show that a very-slow progressing patient presents with a distinct M1 pathology profile compared to the other patients. 

Their study shows that layer-specific markers of in-vivo pathology can be identified in ALS-patients with a single 7T-MRI measurement after first diagnosis, and that such data provide critical insights into the individual disease state. These methods can also be applied to other neurodegenerative, neurological or psychiatric disorders and provide important steps towards an individualized medicine.

Link to the paper: https://doi.org/10.1093/brain/awad351

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