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Functional and structural impairment of transcallosal motor fibres in ALS: a study using transcranial magnetic stimulation, diffusion tensor imaging, and diffusion weighted spectroscopy

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Abstract

Imaging studies showed that the structure of the corpus callosum (CC) is affected in amyotrophic lateral sclerosis (ALS). Some clinical studies also suggest that interhemispheric connectivity is altered, since mirror movements seem to occur in ALS. Finally, reduced interhemispheric inhibition (IHI), studied by transcranial magnetic stimulation (TMS), has been reported. It is not known whether there is any association between these findings. Here, we studied the integrity of the CC in ALS on the morphological, the functional, the electrophysiological, and the clinical level. Twenty-seven right-handed ALS patients and 21 healthy right-handed controls were included. Mirror activity (MA) was quantified using surface EMG. Diffusion tensor imaging tractography was used to segment the CC and quantify fractional anisotropy (FA). We studied the diffusivity of the intra-axonal markers N-acetylaspartate+N-acetyl aspartyl glutamate D(tNAA) within the CC. IHI was studied as a marker of CC function using a double-pulse TMS protocol. ALS patients showed significantly decreased FA in the motor segment of the CC (p < 0.01), and IHI was significantly reduced compared to controls (p = 0.01). However, no differences were observed regarding D(tNAA) and MA. The morphological as well as the functional integrity of the CC are altered in ALS. IHI was reduced in ALS, associated with decreased FA in the motor CC. Patients did not exhibit increased MA. Also, no differences within the CC were observed using diffusion-weighted spectroscopy. IHI might serve as a marker of transcallosal pathway disruption in ALS, even before clinical deficits become apparent.

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Author notes

  1. Annemarie Hübers

    Present address: Department of Neurology, University Hospital Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Switzerland

  2. I. Ronen and J. Kassubek contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology, University Hospital Ulm, Ulm, Germany

    Annemarie Hübers, Bastian Böckler, Dorothée Lulé, Hans-Peter Müller, Albert Christian Ludolph & Jan Kassubek

  2. Department of Internal Medicine II, Experimental Cardiovascular MRI, University Hospital Ulm, Ulm, Germany

    Alireza Abaei & Volker Rasche

  3. Department of Radiology, Leiden University Medical Center, Leiden, Netherlands

    Ece Ercan, Nathalie Doorenweerd & Itamar Ronen

  4. Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany

    Jens Dreyhaupt

  5. Department of Psychiatry, University Hospital Ulm, Ulm, Germany

    Thomas Kammer

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  1. Annemarie Hübers
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Correspondence to Annemarie Hübers.

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Hübers, A., Böckler, B., Abaei, A. et al. Functional and structural impairment of transcallosal motor fibres in ALS: a study using transcranial magnetic stimulation, diffusion tensor imaging, and diffusion weighted spectroscopy. Brain Imaging and Behavior 15, 748–757 (2021). https://doi.org/10.1007/s11682-020-00282-x

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