Faculty Profiles - NAGANAWA, Shinji

Papers - NAGANAWA, Shinji

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Clinical Results of T1 Glottic Cancer Treated with Radiotherapy Using 2.25 Gy per Fractions: A Multicenter Survey in Clinical Practice Reviewed

Oie Y., Itoh Y., Kawamura M., Takase Y., Murao T., Ishihara S., Nomoto Y., Hirasawa N., Asano A., Yamakawa K., Ito J., Naganawa S.

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS Vol. 105 ( 1 ) page： E366 - E367 2019.9

Development of Three-Dimensional Printed Compensator for Improvement of Dose Distribution in Boron Neutron Capture Therapy: A Preliminary Study Reviewed

Kamomae T., Sakurai Y., Oita M., Takata T., Niimi T., Matsumura T., Saito T., Komada T., Kato K., Itoh Y., Naganawa S.

MEDICAL PHYSICS Vol. 46 ( 6 ) page： E411 - E411 2019.6

Evaluation of Ra-223 therapy on bone metastases of prostate cancer by F-18-fluoride PET/CT, F-18-FDG PET/CT and bone scintigraphy/SPECT Reviewed

Kato Katsuhiko, Odagawa Tetsuro, Fujita Naotoshi, Tsutsumi Yoshinori, Abe Shinji, Yamamoto Seiichi, Naganawa Shinji

JOURNAL OF NUCLEAR MEDICINE Vol. 60 ( supplement 1 ) page： 534 - 534 2019.5

Influence of implanted metals in new CT reconstruction algorithm for radiotherapy treatment planning Reviewed

Kamomae T., Nakaya T., Kawabata F., Okudaira K., Kumagai M., Oguchi H., Itoh Y., Naganawa S.

RADIOTHERAPY AND ONCOLOGY Vol. 133 page： S1132 - S1132 2019.4

Diagnostic Radiology Service in Japan. Reviewed

Shinji Naganawa, Yukunori Korogi

Japanese journal of radiology Vol. 36 ( 10 ) page： 575 - 578 2018.10

Longitudinal Findings of MRI and PET in West Syndrome with Subtle Focal Cortical Dysplasia Reviewed

Sakaguchi Y., Kidokoro H., Ogawa C., Okai Y., Ito Y., Yamamoto H., Ohno A., Nakata T., Tsuji T., Nakane T., Kawai H., Kato K., Naganawa S., Natsume J.

AMERICAN JOURNAL OF NEURORADIOLOGY Vol. 39 ( 10 ) page： 1932 - 1937 2018.10

PREDICTION OF INTRACRANIAL ARTERIAL STENOSIS PROGRESSION IN PATIENTS WITH MOYAMOYA VASCULOPATHY: CONTRAST-ENHANCED HIGH-RESOLUTION MAGNETIC RESONANCE VESSELWALL IMAGING Reviewed

Muraoka S., Araki Y., Taoka T., Kawai H., Okamoto S., Uda K., Ota S., Naganawa S., Wakabayashi T.

INTERNATIONAL JOURNAL OF STROKE Vol. 13 page： 32 - 32 2018.10

Prediction of recurrence using volume-based metabolic index obtained by preoperative FDG-PET for non-small-cell lung cancer Reviewed

Ito S., Iwano S., Kato K., Naganawa S.

EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING Vol. 45 page： S506 - S506 2018.10

Corpus callosal involvement is correlated with cognitive impairment in multiple system atrophy. Reviewed International journal

Kazuhiro Hara, Hirohisa Watanabe, Epifanio Bagarinao, Kazuya Kawabata, Noritaka Yoneyama, Reiko Ohdake, Kazunori Imai, Michihito Masuda, Takamasa Yokoi, Aya Ogura, Takashi Tsuboi, Mizuki Ito, Naoki Atsuta, Hisayoshi Niwa, Toshiaki Taoka, Satoshi Maesawa, Shinji Naganawa, Masahisa Katsuno, Gen Sobue

Journal of neurology Vol. 265 ( 9 ) page： 2079 - 2087 2018.9

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: We examined the anatomical involvement related to cognitive impairment in patients with multiple system atrophy (MSA). METHODS: We examined 30 patients with probable MSA and 15 healthy controls. All MSA patients were assessed by the Unified MSA-Rating scale and Addenbrooke's Cognitive Examination-Revised (ACE-R). We classified 15 MSA patients with ACE-R scores > 88 as having normal cognition (MSA-NC) and 15 with scores ≤ 88 as having cognitive impairment (MSA-CI). All subjects underwent 3 T MRI scanning and were investigated using voxel-based morphometry and diffusion tensor imaging. RESULTS: Both the MSA-NC and MSA-CI patients exhibited cerebellar but not cerebral atrophy in voxel-based morphometry compared to controls. In contrast, tract-based spatial statistics revealed widespread and significantly decreased fractional anisotropy (FA) values, as well as increased mean diffusivity, radial diffusivity, and axial diffusivity in both the cerebrum and cerebellum in MSA-CI patients compared to controls. MSA-NC patients also exhibited similar involvement of the cerebellum but less extensive involvement of the cerebrum compared with the MSA-CI patients. In particular, FA values in MSA-CI patients were significantly decreased in the anterior part of the left corpus callosum compared with those in MSA-NC patients. The mean FA values in the left anterior part of the corpus callosum were significantly correlated with total ACE-R scores and subscores (memory, fluency, and language) in MSA patients. CONCLUSIONS: Decreased FA values in the anterior corpus callosum showed a significant correlation with cognitive impairment in MSA.

DOI： 10.1007/s00415-018-8923-7

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Prediction of Intracranial Arterial Stenosis Progression in Patients with Moyamoya Vasculopathy: Contrast-Enhanced High-Resolution Magnetic Resonance Vessel Wall Imaging. Reviewed International journal

Shinsuke Muraoka, Yoshio Araki, Toshiaki Taoka, Hisashi Kawai, Sho Okamoto, Kenji Uda, Shinji Ota, Shinji Naganawa, Toshihiko Wakabayashi

World neurosurgery Vol. 116 page： e1114 - e1121 2018.8

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: Moyamoya vasculopathy (MMV) is characterized by progressive stenosis of the intracranial arteries. MMV currently has no curative treatments, and cerebral ischemia and hemorrhage are the major outcomes. Evaluation of the stroke risk of each patient resulting from the progression of intracranial arterial stenosis is clinically important. METHODS: We prospectively reviewed patients with intracranial arterial stenosis and already diagnosed MMV. High-resolution magnetic resonance imaging using contrast agent is the novel vessel wall imaging (VWI) technique for directly evaluating vascular walls and intracranial artery disease. All patients underwent high-resolution vessel wall imaging and magnetic resonance angiography at the time of registration, and they underwent follow-up magnetic resonance angiography. The Fisher exact test was used to assess associations between the degrees of wall enhancement and between stable and progressive intracranial arterial stenosis. RESULTS: A total of 24 patients (17 female; mean age, 36.1 ± 16.8 years; range 3-67 years) with MMV were consecutively recruited to this study. Progression of stenosis was shown in 6 lesions (66.6%) on strong enhancement, 2 lesions (12.5%) on mild enhancement, and 1 lesion (4.3%) on lack of enhancement. Arterial vessel wall enhancement in MMV patients correlated closely with progression of intracranial arterial stenosis (P = 0.002). CONCLUSIONS: Arterial vessel wall enhancement in MMV patients was closely related to progression of intracranial arterial stenosis. Strong enhancement of the intracranial vessel wall was associated with intracranial arterial stenosis progression, and lack of enhancement correlated with the stability of intracranial arterial stenosis.

DOI： 10.1016/j.wneu.2018.05.181

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Predictive factors for the outcomes of initial I-131 low-dose ablation therapy to Japanese patients with differentiated thyroid cancer. Reviewed

Shinji Ito, Shingo Iwano, Katsuhiko Kato, Shinji Naganawa

Annals of nuclear medicine Vol. 32 ( 6 ) page： 418 - 424 2018.7

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: To identify prognostic factors associated with a low-iodine diet (LID) and the amount of remnant thyroid tissue in Japanese patients with differentiated thyroid cancer (DTC) who received initial I-131 remnant ablation (RAI) using a fixed low dose of I-131 (1110 MBq). PATIENTS AND METHODS: In this prospective study, we enrolled 45 patients. Patients were classified into a self-managed LID group and a strict LID group. We measured the urinary iodine concentration on the day of RAI after patients consumed LID for 2 weeks. Thyroid-stimulating hormone-induced thyroglobulin (Tg) levels and I-131 uptake by the remnant thyroid tissue were also evaluated. A response-evaluation whole-body scan (WBS) was performed 6-8 months after RAI to determine the outcome of the therapy. RESULTS: Post-LID urinary iodine levels of the strict LID group tended to be lower than those of the self-managed LID group. Twenty-five cases (56%) showed absence of uptake, whereas 20 cases (44%) showed residual uptake on the response-evaluation WBS. There were no significant differences between "absence" and "residual" groups in urinary iodine concentrations and Tg levels (p = 0.253 and p = 0.234, respectively). However, significant differences were observed in I-131 uptake by the thyroid bed (p = 0.035). CONCLUSIONS: For patients following the current Japanese method of a 2-week LID, the urinary iodine concentration was not a predictive factor for the successful outcome of RAI. In contrast, low I-131 uptake by the thyroid bed, revealed by the scintigram after RAI, may serve as a favorable predictive factor.

DOI： 10.1007/s12149-018-1261-0

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Myocardial motion analysis based on an optical flow method using tagged MR images. Reviewed

Daiki Tabata, Haruo Isoda, Kaori Kato, Hiroki Matsubara, Takafumi Kosugi, Takashi Kosugi, Masaki Terada, Atsushi Fukuyama, Yoshiaki Komori, Shinji Naganawa

Radiological physics and technology Vol. 11 ( 2 ) page： 202 - 211 2018.6

Language：English Publishing type：Research paper (scientific journal)

We developed a method of velocimetry based on an optical flow method using quantitative analyses of tagged magnetic resonance (MR) images (tagged MR-optical flow velocimetry, tMR-O velocimetry). The purpose of our study was to examine the accuracy of measurement of the proposed tMR-O velocimetry. We performed retrospective pseudo-electrocardiogram (ECG) gating tagged cine MR imaging on a rotating phantom. We optimized imaging parameters for tagged MR imaging, and validated the accuracy of tMR-O velocimetry. Our results indicated that the difference between the reference velocities and the computed velocities measured using optimal imaging parameters was less than 1%. In addition, we performed tMR-O velocimetry and echocardiography on 10 healthy volunteers, for four sections of the heart (apical, midventricular, and basal sections aligned with the short-axis, and a four-chamber section aligned with the long-axis), and obtained radial and longitudinal myocardial velocities in these sections. We compared the myocardial velocities obtained using tMR-O velocimetry with those obtained using echocardiography. Our results showed good agreement between tMR-O velocimetry and echocardiography in the radial myocardial velocities in three short-axial sections and longitudinal myocardial velocities on the midventricular portion of the four-chamber section in the long-axis. In the study conducted on the rotating phantom, tMR-O velocimetry showed high accuracy; moreover, in the healthy volunteers, the myocardial velocities obtained using tMR-O velocimetry were relatively similar to those obtained using echocardiography. In conclusion, tMR-O velocimetry is a potentially feasible method for analyzing myocardial motion in the human heart.

DOI： 10.1007/s12194-018-0456-3

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Study Protocol: Prospective Study of Concurrent Chemoradiotherapy with S-1 and Hypofractionated Radiotherapy for Outpatients with Early Glottic Squamous Cell Carcinomas Reviewed International journal

Kana Kimura, Yoshiyuki Itoh, Tohru Okada, Seiji Kubota, Mariko Kawamura, Rie Nakahara, Yumi Oie, Yuka Kozai, Yuuki Takase, Hidenori Tsuzuki, Naoki Nishio, Mariko Hiramatsu, Yasushi Fujimoto, Takefumi Mizutani, Akihiro Hirakawa, Shinji Naganawa

Asian Pacific journal of cancer prevention : APJCP Vol. 19 ( 5 ) page： 1195 - 1199 2018.5

Language：English Publishing type：Research paper (scientific journal)

Background: The recommended treatment strategies for early glottic carcinoma with intent of larynx preservation are
primarily radiotherapy. However, the outcomes of radiotherapy for bulky T1 or T2 glottic carcinoma are unsatisfactory.
We designed a protocol consisting of concurrent chemoradiotherapy using S-1 as the radiosensitizer. We have performed
this protocol in patients with favorable T2 lesions and demonstrated its efficacy and safety. In contrast, we have
treated non-bulky T1 glottic carcinomas with 2.25 Gy per fraction, for a total of 25-28 fractions, starting in 2011 to
improve efficacy and shorten the treatment period. Since this treatment strategy was implemented for T1 disease, no
local failure has occurred to date, and it appears to be almost as safe as radiotherapy using 2.0 Gy per fraction. With
the aim of improving the local control rate and shortening the treatment period primarily for favorable T2 disease, we
changed the dose of radiation in our protocol from 2.0 Gy to 2.25 Gy per fraction, for a total of 25 fractions (from 30
fractions). The present study aims to evaluate the efficacy and safety of this new protocol. Methods: This study will
be conducted as a clinical, prospective, single-armed, non-randomized trial. Patients are to receive S-1 (55.3 mg /m2
/day, once daily) and radiotherapy (2.25 Gy per fraction, for a total of 25 fractions). S-1 and radiotherapy are started
on the same day that radiotherapy is performed, 3-6 hours after oral administration of S-1. The primary study aim is
the 3-year local control rate. The secondary study aims are overall survival, voice-preservation survival, disease-free
survival, complete response rate, completion rate, and toxicity. Result and conclusion: This is the first single-center,
non-randomized, prospective study of concurrent chemoradiotherapy with S-1 and hypofractionated radiotherapy to
be conducted. The trial will evaluate the efficacy and safety of our protocol.

DOI： 10.22034/APJCP.2018.19.5.1195

PubMed

Evaluation of the tumoricidal and pain relief effects of Sr-89 on bone metastases of cancer by F-18-fluoride PET/CT, F-18-FDG PET/CT, bone scintigraphy/SPECT, and follow-up Reviewed

Kato Katsuhiko, Odagawa Tetsuro, Fujita Naotoshi, Tsutsumi Yoshinori, Matsuzawa Shinichiro, Mukumoto Ryuto, Hasegawa Chinatsu, Abe Shinji, Naganawa Shinji

JOURNAL OF NUCLEAR MEDICINE Vol. 59 page： . 2018.5

Efficacy of percutaneous transhepatic portal vein embolization using gelatin sponge particles and metal coils. Reviewed International journal

Tomohiro Komada, Kojiro Suzuki, Takashi Mizuno, Tomoki Ebata, Masaya Matsushima, Shinji Naganawa, Masato Nagino

Acta radiologica open Vol. 7 ( 4 ) page： 2058460118769687 - 2058460118769687 2018.4

Language：English Publishing type：Research paper (scientific journal)

Background: Percutaneous transhepatic portal vein embolization (PTPE) can increase the future liver remnant (FLR) volume before extended liver resection; however, there is no current consensus regarding the best embolic material for PTPE. Purpose: To evaluate the efficacy of PTPE using gelatin sponge particles and coils. Material and Methods: The medical records of 136 patients who underwent PTPE using gelatin sponge particles and metal coils were retrospectively reviewed. We evaluated the procedural details, liver volume on CT, and clinical status before and after PTPE. Results: The mean FLR volume increased significantly from 390 ± 147 cm3 to 508 ± 141 cm3 (P < 0.001). A mean of 22.1 ± 9.4 days after PTPE, the mean increase in the ratio of FLR volume to total liver volume was 9.4 ± 6.5%. Complications related to PTPE occurred in five patients, including arterial damage (n = 4) and biloma (n = 1). The white blood cell count and C-reactive protein level increased significantly and then returned to baseline within seven days. Aspartate aminotransferase and alanine aminotransferase showed no significant changes. Fever (defined by the Common Terminology Criteria for Adverse Events v4.0) was reported in 74 patients (54%), but it was generally mild (Grade 1/2; n = 72). None of the patients experienced severe complications that required cancellation of surgery. Conclusion: PTPE with gelatin sponge particles and coils may impose low physical stress on patients and is a safe method of inducing a significant increase of FLR.

DOI： 10.1177/2058460118769687

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FDG PET/CT Overcomes Discordance Between Clinical and Pathologic TNM Classification of Small-size Primary Lung Cancer: Influence on Postoperative Prognosis. Reviewed International journal

Hiroyasu Umakoshi, Shingo Iwano, Kohei Yokoi, Shinji Ito, Rintaro Ito, Koji Kawaguchi, Takayuki Fukui, Shinji Naganawa

Clinical lung cancer Vol. 19 ( 1 ) page： e37 - e45 2018.1

Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: We aimed to determine the concordance between the clinical stage (c-stage) and pathologic stage (p-stage) for patients with small-size lung cancer. Additionally we searched for prognostic factors other than the TNM stage. PATIENTS AND METHODS: We retrospectively reviewed the preoperative multidetector computed tomography (CT) and positron emission tomography/CT reports, surgical records, and pathologic reports of patients with primary lung cancer ≤ 3 cm. The Union for International Cancer Control TNM seventh edition classification of c-stage and p-stage were compared. The tumors were classified into multiple subgroups by concordance or discordance between the c-stage and p-stage. Disease-free survival (DFS) was assessed using survival analysis to assess the tumor characteristics that were predictive of prognosis. RESULTS: A total of 289 surgically resected primary lung cancers were evaluated. The concordance between c-stage and p-stage was 65.4%, with moderate reproducibility (kappa coefficient, 0.467). The upstaging rate from c-stage I to p-stage II-IV was 9.4%, and these patients had significantly worse DFS than those with a concordant stage I classification (P < .001). The main reason for upstaging was an underestimation of metastases to the hilar lymph nodes (n = 7) or mediastinal lymph nodes (n = 11). A multivariate Cox proportional hazards model showed that the significant predictive factors for DFS were p-stage (hazard ratio, 1.342; P = .003) and maximum standardized uptake value on positron emission tomography/CT (hazard ratio, 12.162; P = .001). CONCLUSION: The concordance rate between c-stage and p-stage for small primary lung cancers had moderate reproducibility. Discordance between c-stage I and p-stage II-IV significantly affected DFS. The maximum standardized uptake value of the primary lesion was an independent prognostic factor, and combining it with c-stage might improve the prediction of therapeutic outcomes.

DOI： 10.1016/j.cllc.2017.05.021

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Effects of Gradient Coil Noise and Gradient Coil Replacement on the Reproducibility of Resting State Networks. Reviewed International journal

Epifanio Bagarinao, Erina Tsuzuki, Yukina Yoshida, Yohei Ozawa, Maki Kuzuya, Takashi Otani, Shuji Koyama, Haruo Isoda, Hirohisa Watanabe, Satoshi Maesawa, Shinji Naganawa, Gen Sobue

Frontiers in human neuroscience Vol. 12 page： 148 - 148 2018

Language：English Publishing type：Research paper (scientific journal)

The stability of the MRI scanner throughout a given study is critical in minimizing hardware-induced variability in the acquired imaging data set. However, MRI scanners do malfunction at times, which could generate image artifacts and would require the replacement of a major component such as its gradient coil. In this article, we examined the effect of low intensity, randomly occurring hardware-related noise due to a faulty gradient coil on brain morphometric measures derived from T1-weighted images and resting state networks (RSNs) constructed from resting state functional MRI. We also introduced a method to detect and minimize the effect of the noise associated with a faulty gradient coil. Finally, we assessed the reproducibility of these morphometric measures and RSNs before and after gradient coil replacement. Our results showed that gradient coil noise, even at relatively low intensities, could introduce a large number of voxels exhibiting spurious significant connectivity changes in several RSNs. However, censoring the affected volumes during the analysis could minimize, if not completely eliminate, these spurious connectivity changes and could lead to reproducible RSNs even after gradient coil replacement.

DOI： 10.3389/fnhum.2018.00148

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Dosimetric feasibility of using tungsten-based functional paper for flexible chest wall protectors in intraoperative electron radiotherapy for breast cancer. Reviewed International journal

Takeshi Kamomae, Hajime Monzen, Mariko Kawamura, Kuniyasu Okudaira, Takayoshi Nakaya, Takashi Mukoyama, Yoshikazu Miyake, Yoshitomo Ishihara, Yoshiyuki Itoh, Shinji Naganawa

Physics in medicine and biology Vol. 63 ( 1 ) page： 015006 - 015006 2017.12

Language：English Publishing type：Research paper (scientific journal)

Intraoperative electron radiotherapy (IOERT), which is an accelerated partial breast irradiation method, has been used for early-stage breast cancer treatment. In IOERT, a protective disk is inserted behind the target volume to minimize the dose received by normal tissues. However, to use such a disk, the surgical incision must be larger than the field size because the disk is manufactured from stiff and unyielding materials. In this study, the applicability of newly developed tungsten-based functional paper (TFP) was assessed as an alternative to the existing protective disk. The radiation-shielding performance of the TFP was verified through experimental measurements and Monte Carlo simulations. Percentage depth dose curves and lateral dose profiles with and without TFPs were measured and simulated on a dedicated IOERT accelerator. The number of piled-up TFPs was changed from 1 to 40. In the experimental measurements, the relative doses at the exit plane of the TFPs for 9 MeV were 42.7%, 9.2%, 0.2%, and 0.1% with 10, 20, 30, and 40 TFPs, respectively, whereas those for 12 MeV were 63.6%, 27.1%, 8.6%, and 0.2% with 10, 20, 30, and 40 TFPs, respectively. Slight dose enhancements caused by backscatter radiation from the TFPs were observed at the entrance plane of the TFPs at both beam energies. The results of the Monte Carlo simulation indicated the same tendency as the experimental measurements. Based on the experimental and simulated results, the radiation-shielding performances of 30 TFPs for 9 MeV and 40 TFPs for 12 MeV were confirmed to be acceptable and close to those of the existing protective disk. The findings of this study suggest the feasibility of using TFPs as flexible chest wall protectors in IOERT for breast cancer treatment.

DOI： 10.1088/1361-6560/aa96cf

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Three-dimensional printer-generated patient-specific phantom for artificial in vivo dosimetry in radiotherapy quality assurance. Reviewed International journal

Takeshi Kamomae, Hidetoshi Shimizu, Takayoshi Nakaya, Kuniyasu Okudaira, Takahiro Aoyama, Hiroshi Oguchi, Masataka Komori, Mariko Kawamura, Kazuhiro Ohtakara, Hajime Monzen, Yoshiyuki Itoh, Shinji Naganawa

Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) Vol. 44 page： 205 - 211 2017.12

Language：English Publishing type：Research paper (scientific journal)

Pretreatment intensity-modulated radiotherapy quality assurance is performed using simple rectangular or cylindrical phantoms; thus, the dosimetric errors caused by complex patient-specific anatomy are absent in the evaluation objects. In this study, we construct a system for generating patient-specific three-dimensional (3D)-printed phantoms for radiotherapy dosimetry. An anthropomorphic head phantom containing the bone and hollow of the paranasal sinus is scanned by computed tomography (CT). Based on surface rendering data, a patient-specific phantom is formed using a fused-deposition-modeling-based 3D printer, with a polylactic acid filament as the printing material. Radiophotoluminescence glass dosimeters can be inserted in the 3D-printed phantom. The phantom shape, CT value, and absorbed doses are compared between the actual and 3D-printed phantoms. The shape difference between the actual and printed phantoms is less than 1 mm except in the bottom surface region. The average CT value of the infill region in the 3D-printed phantom is -6 ± 18 Hounsfield units (HU) and that of the vertical shell region is 126 ± 18 HU. When the same plans were irradiated, the dose differences were generally less than 2%. These results demonstrate the feasibility of the 3D-printed phantom for artificial in vivo dosimetry in radiotherapy quality assurance.

DOI： 10.1016/j.ejmp.2017.10.005

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Structural MRI correlates of amyotrophic lateral sclerosis progression. Reviewed International journal

Joe Senda, Naoki Atsuta, Hirohisa Watanabe, Epifanio Bagarinao, Kazunori Imai, Daichi Yokoi, Yuichi Riku, Michihito Masuda, Ryoichi Nakamura, Hazuki Watanabe, Mizuki Ito, Masahisa Katsuno, Shinji Naganawa, Gen Sobue

Journal of neurology, neurosurgery, and psychiatry Vol. 88 ( 11 ) page： 901 - 907 2017.11

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Amyotrophic lateral sclerosis (ALS) presents with varying degrees of brain degeneration that can extend beyond the corticospinal tract (CST). Furthermore, the clinical course and progression of ALS varies widely. Brain degeneration detected using structural MRI could reflect disease progression. SUBJECTS AND METHODS: On study registration, 3-Tesla volumetric MRI and diffusion tensor imaging scans were obtained at baseline in 38 healthy controls and 67 patients with sporadic ALS. Patients had Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) scores of ≥36 and did not have the chromosome 9, open reading frame 72 repeat expansion. Six months later, changes in ALSFRS-R (ΔALSFRS-R) scores were calculated and patients were grouped into three categories, namely, patients with slow progression with ΔALSFRS-R scores ≤3 (n=19), intermediate progression with ΔALSFRS-R scores =4, 5 and 6 (n=36) and rapid progression with ΔALSFRS-R scores ≥7 (n=12). We analysed voxel-based morphometry and tract-based spatial statistics among these subgroups and controls. RESULTS: In comparison with controls, patients with ALS showed grey matter atrophy and decreased fractional anisotropy beyond the motor cortex and CST, especially in the frontotemporal lobes and basal ganglia. Moreover, the degree of change was highly proportional to ΔALSFRS-R at the 6-month assessment. CONCLUSION: A more rapid disease progression and poorer functional decline were associated with greater involvement of the extra-motor cortex and basal ganglia, suggesting that the spatial extent of brain involvement can be an indicator of the progression in ALS.

DOI： 10.1136/jnnp-2016-314337

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Papers - NAGANAWA, Shinji