Structural hypothalamic abnormalities in amyotrophic lateral sclerosis (ALS)

Resumo

ALS is a disease that progressively affects the upper and lower motor neurons concomitantly. Early pronounced weight loss is a common symptom, which correlates with survival time. Our hypothesis is that this symptom originates from changes in the hypothalamus, which is essential in metabolic control. Therefore, the objective of this study was to determine if there are volumetric changes in the hypothalamus region, through the Multi-Atlas T1, in patients with ALS compared to a control group, and if there is correlation with clinical parameters.
The mean ALSFRS score and disease duration were 32 and 3.8 years, respectively. ?In the volumetric analyses, there were no significant differences between patients and controls regarding Hypothalamus, Mammillary Body, Nucleus Accumbens , Anterior Basal Forebrain, and right-sided Posterior Basal Forebrain and Claustrum volumes. In contrast, we found left-sided Claustrum (p = 0.0002) and Posterior Basal Forebrain (p = 0.02) atrophy in the ALS group. There was no significant correlation between clinical parameters.
Although there was no significant atrophy in the hypothalamus, nearby areas also involved in metabolic control were found abnormal in the patients. This reiterates the hypothesis that metabolic dysregulation is behind ALS-related cachexia.