ArticleBrain imaging and behavior2026
Fixel-based analysis to detect early fiber-specific white matter alterations in sporadic patients with amyotrophic lateral sclerosis.
Article in Brain imaging and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Fiber-specific white matter (WM) changes are promising neuroimaging markers to evaluate upper motor neuron damage in amyotrophic lateral sclerosis (ALS) patients. However,to our knowledge, no studies have specifically applied fixel-based analysis (FBA) to investigate fiber-specific WM changes in King’s stage 1 ALS patients in vivo.” To fill this gap in the literature, we performed a retrospective analysis to identify early fiber-specific WM alterations in a large group of sporadic early-stage ALS (ALS-ES) patients and their correlation with clinical data. According to the new "Gold Coast" criteria and the King’s clinical staging system, we defined ALS patients at King’s stage 1 as ALS-ES patients, which corresponds to the earliest symptomatic phase . In this study, 64 newly diagnosed ALS-ES patients and 80 demographic-matched healthy controls (HCs) were included. Then, a novel diffusion-weighted imaging-based approach, fixel-based analysis (FBA), was performed to explore fiber-specific WM alterations in ALS-ES patients and HCs. Three FBA metrics, fiber density (FD), fiber-bundle cross-section (FC), and fiber density and cross-section (FDC), were analysed. Compared with HCs, ALS-ES patients had significantly decreased FD values and FDC values mainly in the bilateral corticospinal tract (CST) and corpus callosum (CC) regions. Compared with HCs, in ALS-ES patients, the FC values were significantly decreased mainly in the bilateral CST regions, while were significantly increased in the CC regions. Moreover, FDC values significantly correlated with motor deficits in ALS-ES patients. Our findings suggest that FBA metrics can provide valuable and complementary fixel-level information regarding the early WM degenerative process in ALS.
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