Frontiers in Neurology (Aug 2022)

Structural magnetic resonance imaging findings and histopathological correlations in motor neuron diseases—A systematic review and meta-analysis

  • Charlotte Zejlon,
  • Charlotte Zejlon,
  • Dominik Nakhostin,
  • Sebastian Winklhofer,
  • Athina Pangalu,
  • Zsolt Kulcsar,
  • Sebastian Lewandowski,
  • Johannes Finnsson,
  • Johannes Finnsson,
  • Fredrik Piehl,
  • Fredrik Piehl,
  • Caroline Ingre,
  • Tobias Granberg,
  • Tobias Granberg,
  • Benjamin Victor Ineichen,
  • Benjamin Victor Ineichen,
  • Benjamin Victor Ineichen

DOI
https://doi.org/10.3389/fneur.2022.947347
Journal volume & issue
Vol. 13

Abstract

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ObjectivesThe lack of systematic evidence on neuroimaging findings in motor neuron diseases (MND) hampers the diagnostic utility of magnetic resonance imaging (MRI). Thus, we aimed at performing a systematic review and meta-analysis of MRI features in MND including their histopathological correlation.MethodsIn a comprehensive literature search, out of 5941 unique publications, 223 records assessing brain and spinal cord MRI findings in MND were eligible for a qualitative synthesis. 21 records were included in a random effect model meta-analysis.ResultsOur meta-analysis shows that both T2-hyperintensities along the corticospinal tracts (CST) and motor cortex T2*-hypointensitites, also called “motor band sign”, are more prevalent in ALS patients compared to controls [OR 2.21 (95%-CI: 1.40–3.49) and 10.85 (95%-CI: 3.74–31.44), respectively]. These two imaging findings correlate to focal axonal degeneration/myelin pallor or glial iron deposition on histopathology, respectively. Additionally, certain clinical MND phenotypes such as amyotrophic lateral sclerosis (ALS) seem to present with distinct CNS atrophy patterns.ConclusionsAlthough CST T2-hyperintensities and the “motor band sign” are non-specific imaging features, they can be leveraged for diagnostic workup of suspected MND cases, together with certain brain atrophy patterns. Collectively, this study provides high-grade evidence for the usefulness of MRI in the diagnostic workup of suspected MND cases.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020182682.

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