Imaging Analysis Platform May Help Diagnose ALS

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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An imaging analysis platform that examines the brain’s white matter in MRI scans could help to diagnose amyotrophic lateral sclerosis (ALS), a new study suggests.

The results were presented by Braintale at the European Academy of Neurology (EAN 2022) Congress, held both digitally and in Vienna, Austria. The poster was titled, “Evaluation of a clinically-validated web-based analysis MRI platform to provide biomarkers in ALS” (page #604).

“The presented exploratory study shows the excellent potential of both diagnostics and disease monitoring for ALS patients based on powerful neuroimaging approaches as developed by Braintale,” Pierre-François Pradat, MD, PhD, said in a press release. Pradat is a neurologist at the Pitié-Salpêtrière Hospital and co-author of the poster.

ALS is caused by the gradual deterioration and death of motor neurons, the nerve cells that control movement. Upper motor neurons carry signals from the brain to the spinal cord, and then lower motor neurons transmit the signal from the spinal cord out to the rest of the body.

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Diagnosing ALS often is a complex and lengthy process involving monitoring symptoms over time and clinical tests to rule out other conditions. According to Braintale, the average time from symptom onset to diagnosis is about a year, and consequently patients experience delays in receiving care.

Diffusion tensor imaging, or DTI, is a type of imaging analysis that can be done via MRI scans. This type of imaging is especially useful for detecting alterations to the brain’s white matter — parts of brain tissue that contain mostly nerve fibers connecting different brain regions. White matter makes up about 80% of the human brain, but it has been “long underestimated in neurosciences,” according to Braintale.

The company’s platform uses a combination of artificial intelligence-based analyses to identify white matter abnormalities based on scans acquired via MRI/DTI. In ALS, these may serve as a proxy for identifying damage to upper motor neurons.

“The platform can provide proxies of upper motor neuron degeneration in ALS patients, with or without clinical signs, and could be implemented in a clinical setting for diagnosis and decision-making or surrogate endpoint in clinical trials,” Pradat said.

Here, using data from a clinical trial (NCT03694132) sponsored by France’s Institut National de la Santé Et de la Recherche Médicale, researchers employed Braintale’s platform to analyze MRI/DTI images from 24 ALS patients and 22 age- and sex-matched controls.

Results showed that an imaging metric called mean diffusivity (MD), a measure of water diffusion in the brain, was significantly higher in ALS patients than controls in disease-relevant brain regions, specifically the posterior limb of internal capsule and cerebral peduncle.

The difference in the MD of the cerebral peduncle was significant for the subset of ALS patients who showed no overt clinical signs of upper motor neuron degeneration, the researchers noted. Analyses also showed that MD scores in the posterior limb of internal capsule were associated significantly with the severity of ALS symptoms, as measured by the ALS Functional Rating Scale-Revised score.

Collectively, these data suggest that Braintale’s platform “can provide DTI metrics proxies of upper [motor neuron] degeneration in ALS patients even without clinical signs,” the researchers concluded.

“EAN presented data opens additional perspective for Braintale to change the game in rare neurological conditions such as ALS as a proof-of-concept of the relevance of white matter assessment in the diagnostic and monitoring of patients. The whole team is committed to developing relevant solutions to enable better care for patients suffering from this devastating disease,” said Vincent Perlbarg, co-founder and chief scientific officer of Braintale.