Structural atrophy and functional disturbance in the thalamic nuclei of patients with amyotrophic lateral sclerosis.

OBJECTIVE

This study investigated the structural and functional impairments in thalamic nuclei in amyotrophic lateral sclerosis (ALS) and evaluated their associations with disease severity and diagnostic value.

METHODS

This study was conducted on T1-weighted and resting-state functional magnetic resonance images from 71 ALS patients and 61 healthy controls. In each hemisphere, the thalamus was parcellated into 25 nuclei and subsequently grouped into 6 subregions. The volume and amplitude of low-frequency fluctuation (ALFF, reflecting spontaneous neural activity) in each thalamic subregion were measured and compared between groups. These metrics were then used for correlation and diagnostic analyses.

RESULTS

A volumetric reduction was observed in the bilateral anterior, intralaminar, ventral, and left medial thalamic subregions in the ALS patients (FWE-corrected P < 0.05). A decreased ALFF was observed in the right anterior and ventral thalamic subregions of patients with ALS (FWE-corrected P < 0.05). The volumes of the bilateral intralaminar (left: r = 0.304, P = 0.011; right: r = 0.281, P = 0.018) and ventral (left: r = 0.355, P = 0.003; right: r = 0.335, P = 0.005) thalamic subregions were correlated with disease severity. Compared with the whole-thalamic measurements, the volumetric and ALFF measurements of thalamic subregion demonstrated greater diagnostic performance. The combined volumetric and ALFF measurements in the thalamic subregions further resulted in a significantly increased AUC (0.865, P < 0.001).

CONCLUSIONS

Selective structural and functional damage to thalamic subregions is a feature of ALS and could potentially contribute to future diagnostic approaches and assessments of disease severity.