Amyotrophic lateral sclerosis (ALS) is a rapidly progressing neurodegenerative disease of primary cortical neuronal pathology and central nervous system multisystem involvement including related white matter. Based on previous findings of early myelination changes we aimed to investigate the spatial distribution of changes of markers of axonal (diffusion) and myelin (relaxation) integrity of the related motor corticospinal tract (CST). We found different pattern with minor, predominantly diffusion or predominantly relaxation, and extensive ubiquitary alteration. However, heterogeneous distribution of changes suggest a non-uniform secondary CST degeneration and limited prognostic value of ALS disease course.
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