Magnetic Resonance Neuroimaging in Amyotrophic Lateral Sclerosis: A Comprehensive Umbrella Review of 18 Studies

<b>Background/Objectives:</b> Despite extensive research, the underlying causes of amyotrophic lateral sclerosis (ALS) remain unclear. This umbrella review aims to synthesize a vast body of evidence from advanced magnetic resonance imaging (MRI) studies of ALS, encompassing a wide range...

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Main Authors: Sadegh Ghaderi, Sana Mohammadi, Farzad Fatehi
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/15/7/715
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author Sadegh Ghaderi
Sana Mohammadi
Farzad Fatehi
author_facet Sadegh Ghaderi
Sana Mohammadi
Farzad Fatehi
author_sort Sadegh Ghaderi
collection DOAJ
description <b>Background/Objectives:</b> Despite extensive research, the underlying causes of amyotrophic lateral sclerosis (ALS) remain unclear. This umbrella review aims to synthesize a vast body of evidence from advanced magnetic resonance imaging (MRI) studies of ALS, encompassing a wide range of neuroimaging techniques and patient cohorts. <b>Methods:</b> Following the PRISMA guidelines, we conducted an extensive search of four databases (PubMed, Scopus, Web of Science, and Embase) for articles published until 3 December 2024. Data extraction and quality assessment were independently performed using the AMSTAR2 tool. <b>Results:</b> This review included 18 studies that incorporated data from over 29,000 ALS patients. Structural MRI consistently showed gray matter atrophy in the motor and extra-motor regions, with significant white matter (WM) atrophy in the corticospinal tract and corpus callosum. Magnetic resonance spectroscopy revealed metabolic disruptions, including reduced N-acetylaspartate and elevated choline levels. Functional MRI studies have demonstrated altered brain activation patterns and functional connectivity, reflecting compensatory mechanisms and neurodegeneration. fMRI also demonstrated disrupted motor network connectivity and alterations in the default mode network. Diffusion MRI highlighted microstructural changes, particularly reduced fractional anisotropy in the WM tracts. Susceptibility-weighted imaging and quantitative susceptibility mapping revealed iron accumulation in the motor cortex and non-motor regions. Perfusion MRI indicated hypoperfusion in regions associated with cognitive impairment. <b>Conclusions:</b> Multiparametric MRI consistently highlights widespread structural, functional, and metabolic changes in ALS, reflecting neurodegeneration and compensatory mechanisms.
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spelling doaj-art-bfe53706493747cfbd9e021f0e0b67962025-08-20T03:58:26ZengMDPI AGBrain Sciences2076-34252025-07-0115771510.3390/brainsci15070715Magnetic Resonance Neuroimaging in Amyotrophic Lateral Sclerosis: A Comprehensive Umbrella Review of 18 StudiesSadegh Ghaderi0Sana Mohammadi1Farzad Fatehi2Neuromuscular Research Center, Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1416634793, IranNeuromuscular Research Center, Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1416634793, IranNeuromuscular Research Center, Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1416634793, Iran<b>Background/Objectives:</b> Despite extensive research, the underlying causes of amyotrophic lateral sclerosis (ALS) remain unclear. This umbrella review aims to synthesize a vast body of evidence from advanced magnetic resonance imaging (MRI) studies of ALS, encompassing a wide range of neuroimaging techniques and patient cohorts. <b>Methods:</b> Following the PRISMA guidelines, we conducted an extensive search of four databases (PubMed, Scopus, Web of Science, and Embase) for articles published until 3 December 2024. Data extraction and quality assessment were independently performed using the AMSTAR2 tool. <b>Results:</b> This review included 18 studies that incorporated data from over 29,000 ALS patients. Structural MRI consistently showed gray matter atrophy in the motor and extra-motor regions, with significant white matter (WM) atrophy in the corticospinal tract and corpus callosum. Magnetic resonance spectroscopy revealed metabolic disruptions, including reduced N-acetylaspartate and elevated choline levels. Functional MRI studies have demonstrated altered brain activation patterns and functional connectivity, reflecting compensatory mechanisms and neurodegeneration. fMRI also demonstrated disrupted motor network connectivity and alterations in the default mode network. Diffusion MRI highlighted microstructural changes, particularly reduced fractional anisotropy in the WM tracts. Susceptibility-weighted imaging and quantitative susceptibility mapping revealed iron accumulation in the motor cortex and non-motor regions. Perfusion MRI indicated hypoperfusion in regions associated with cognitive impairment. <b>Conclusions:</b> Multiparametric MRI consistently highlights widespread structural, functional, and metabolic changes in ALS, reflecting neurodegeneration and compensatory mechanisms.https://www.mdpi.com/2076-3425/15/7/715amyotrophic lateral sclerosisfunctional MRIdiffusion MRIperfusion MRIsusceptibility-weighted imagingquantitative susceptibility mapping
spellingShingle Sadegh Ghaderi
Sana Mohammadi
Farzad Fatehi
Magnetic Resonance Neuroimaging in Amyotrophic Lateral Sclerosis: A Comprehensive Umbrella Review of 18 Studies
Brain Sciences
amyotrophic lateral sclerosis
functional MRI
diffusion MRI
perfusion MRI
susceptibility-weighted imaging
quantitative susceptibility mapping
title Magnetic Resonance Neuroimaging in Amyotrophic Lateral Sclerosis: A Comprehensive Umbrella Review of 18 Studies
title_full Magnetic Resonance Neuroimaging in Amyotrophic Lateral Sclerosis: A Comprehensive Umbrella Review of 18 Studies
title_fullStr Magnetic Resonance Neuroimaging in Amyotrophic Lateral Sclerosis: A Comprehensive Umbrella Review of 18 Studies
title_full_unstemmed Magnetic Resonance Neuroimaging in Amyotrophic Lateral Sclerosis: A Comprehensive Umbrella Review of 18 Studies
title_short Magnetic Resonance Neuroimaging in Amyotrophic Lateral Sclerosis: A Comprehensive Umbrella Review of 18 Studies
title_sort magnetic resonance neuroimaging in amyotrophic lateral sclerosis a comprehensive umbrella review of 18 studies
topic amyotrophic lateral sclerosis
functional MRI
diffusion MRI
perfusion MRI
susceptibility-weighted imaging
quantitative susceptibility mapping
url https://www.mdpi.com/2076-3425/15/7/715
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AT sanamohammadi magneticresonanceneuroimaginginamyotrophiclateralsclerosisacomprehensiveumbrellareviewof18studies
AT farzadfatehi magneticresonanceneuroimaginginamyotrophiclateralsclerosisacomprehensiveumbrellareviewof18studies