In vivo mapping of sodium homeostasis disturbances in individual ALS patients: A brain 23Na MRI study.

<h4>Objective</h4>Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by significant heterogeneity among patients. 23Na MRI maps abnormal sodium homeostasis that reflects metabolic alterations and energetic failure contributing to the neurodegenerative proces...

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Main Authors: Aude-Marie Grapperon, Mohamed Mounir El Mendili, Adil Maarouf, Jean-Philippe Ranjeva, Maxime Guye, Annie Verschueren, Shahram Attarian, Wafaa Zaaraoui
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0316916
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author Aude-Marie Grapperon
Mohamed Mounir El Mendili
Adil Maarouf
Jean-Philippe Ranjeva
Maxime Guye
Annie Verschueren
Shahram Attarian
Wafaa Zaaraoui
author_facet Aude-Marie Grapperon
Mohamed Mounir El Mendili
Adil Maarouf
Jean-Philippe Ranjeva
Maxime Guye
Annie Verschueren
Shahram Attarian
Wafaa Zaaraoui
author_sort Aude-Marie Grapperon
collection DOAJ
description <h4>Objective</h4>Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by significant heterogeneity among patients. 23Na MRI maps abnormal sodium homeostasis that reflects metabolic alterations and energetic failure contributing to the neurodegenerative process. In this study, we investigated disease severity at the individual level in ALS patients using brain 23Na MRI.<h4>Methods</h4>1H and 23Na brain MRI were collected prospectively from 28 ALS patients. Individual map of abnormal total sodium concentration (TSC) was computed using voxel-based statistical mapping for each patient compared to a local database of 62 healthy controls. Clinical data included the revised ALS functional rating scale (ALSFRS-R), ALSFRS-R slope, ALSFRS-R at 6-month and survival time.<h4>Results</h4>Individual maps quantifying voxels with TSC increase evidenced a high heterogeneity between patients consistent with clinical presentation. The main areas involved were the corticospinal tracts. Half of patients showed abnormal TSC increase within more than 1% of whole brain voxels. Patients with TSC increase had worse clinical severity: higher ALSFRS-R slope (p = 0.02), lower ALSFRS-R at 6-month (p = 0.04), and shorter survival (p = 0.04). ALS patients with limited TSC increase had slower progression of disability or predominant lower motor neuron phenotype or shorter disease duration.<h4>Discussion</h4>This study mapping sodium homeostasis disturbances at the individual level in ALS patients through 23Na MRI evidenced heterogeneity of TSC increase among patients associated with clinical presentation and disease severity. These findings suggest that TSC increase detected at the individual level by 23Na MRI may be a useful marker of the clinical heterogeneity of ALS patients, a factor that is likely to greatly influence the results of therapeutic trials.
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spelling doaj-art-a8fe6fd2e4dd49168fb82cf803ee41192025-02-05T05:31:09ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01201e031691610.1371/journal.pone.0316916In vivo mapping of sodium homeostasis disturbances in individual ALS patients: A brain 23Na MRI study.Aude-Marie GrapperonMohamed Mounir El MendiliAdil MaaroufJean-Philippe RanjevaMaxime GuyeAnnie VerschuerenShahram AttarianWafaa Zaaraoui<h4>Objective</h4>Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by significant heterogeneity among patients. 23Na MRI maps abnormal sodium homeostasis that reflects metabolic alterations and energetic failure contributing to the neurodegenerative process. In this study, we investigated disease severity at the individual level in ALS patients using brain 23Na MRI.<h4>Methods</h4>1H and 23Na brain MRI were collected prospectively from 28 ALS patients. Individual map of abnormal total sodium concentration (TSC) was computed using voxel-based statistical mapping for each patient compared to a local database of 62 healthy controls. Clinical data included the revised ALS functional rating scale (ALSFRS-R), ALSFRS-R slope, ALSFRS-R at 6-month and survival time.<h4>Results</h4>Individual maps quantifying voxels with TSC increase evidenced a high heterogeneity between patients consistent with clinical presentation. The main areas involved were the corticospinal tracts. Half of patients showed abnormal TSC increase within more than 1% of whole brain voxels. Patients with TSC increase had worse clinical severity: higher ALSFRS-R slope (p = 0.02), lower ALSFRS-R at 6-month (p = 0.04), and shorter survival (p = 0.04). ALS patients with limited TSC increase had slower progression of disability or predominant lower motor neuron phenotype or shorter disease duration.<h4>Discussion</h4>This study mapping sodium homeostasis disturbances at the individual level in ALS patients through 23Na MRI evidenced heterogeneity of TSC increase among patients associated with clinical presentation and disease severity. These findings suggest that TSC increase detected at the individual level by 23Na MRI may be a useful marker of the clinical heterogeneity of ALS patients, a factor that is likely to greatly influence the results of therapeutic trials.https://doi.org/10.1371/journal.pone.0316916
spellingShingle Aude-Marie Grapperon
Mohamed Mounir El Mendili
Adil Maarouf
Jean-Philippe Ranjeva
Maxime Guye
Annie Verschueren
Shahram Attarian
Wafaa Zaaraoui
In vivo mapping of sodium homeostasis disturbances in individual ALS patients: A brain 23Na MRI study.
PLoS ONE
title In vivo mapping of sodium homeostasis disturbances in individual ALS patients: A brain 23Na MRI study.
title_full In vivo mapping of sodium homeostasis disturbances in individual ALS patients: A brain 23Na MRI study.
title_fullStr In vivo mapping of sodium homeostasis disturbances in individual ALS patients: A brain 23Na MRI study.
title_full_unstemmed In vivo mapping of sodium homeostasis disturbances in individual ALS patients: A brain 23Na MRI study.
title_short In vivo mapping of sodium homeostasis disturbances in individual ALS patients: A brain 23Na MRI study.
title_sort in vivo mapping of sodium homeostasis disturbances in individual als patients a brain 23na mri study
url https://doi.org/10.1371/journal.pone.0316916
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