have determinate circulating exosomes in biological fluids. have determinate extracellular vesicles in Cerebrospinal Fluid (CSF) in ALS patients for his part Blasso et al. have isolated neurofilaments containing hetero-aggregates in blood of ALS patients. have showed increase of TDP-43 (it is a phosphorylated and ubiquinated cytoplasmic aggregated of neurons and glial cells) in bio fluids and tissues in early step of ALS. Some researchers have been working looking forward markers for early diagnosis of the disease. Cuban National Neurologic and Neurosurgery Institute is ALS reference centre and it reports about 200 new ALS cases by year recently have changed the widely held belief that ALS affects only the motor neuron system, because evidence suggests that ALS is a multisystem neurodegenerative disease that involves sensory and extrapyramidal systems. In Europe and the United States, ALS affects about 2 people per 100,000 habitants per year. It is the third more frequent neurodegenerative diseases. It is characterized by involvement of both motor neurons, median survival time of 2-4 years from onset of symptoms. They could be markers in early ALS diagnostic.Ĭorticospinal tract Postcentral gyrus Corpus callosum Electromyography Amyotrophic lateral sclerosisĪmyotrophic Lateral Sclerosis (ALS) is a fatal and rapidly progressing neurodegenerative disease affecting both upper and lower motor neuron systems. MRI methods show abnormalities in motor and not motor structures of brain in ALS patients. Electrophysiological studies confirmed ALS diagnosis in 100% of cases. Also grey and white matter were reduce in ALS group, in areas such as: cingulate gyrus, anterior portion of occipital lobe, left caudate and putamen nucleus, right claustrum nucleus, lower and medium temporal gyrus bilateral, left precentral and post-central gyrus, corpus callosum, corticospinal tract, bilateral internal capsule, bilateral optical radiation, bilateral lower longitudinal fascicle, bilateral hippocampal fimbriae, bilateral radiated corona and pontocerebellar fibers. Fibers number of cortico-spinal tract and corpus callosum were diminished in ALS group in relation to health group. Fractional Anisotropy was reduced in ALS group in comparison with health group, more significant at cortex, internal capsule and corpus callosum. Anatomic MRI was positive in 50% of the patients. Nerve conduction study was positive in 90% of the patients, SSEP were positive in 60% and EMG abnormalities were observed in 100% of patients. Post processing MRI techniques like voxel based morphometric, diffusion techniques and corticospinal tract and corpus callosum tractography were applied at different levels of the brain structures. 3T MRI image were obtained from the patients and from the health subjects. Sensory and by motor nerve conduction studies, Electromyography, Somato- Sensory Evoked Potentials were done to the patients. During January 2015 to January 2017, twenty patients with ALS diagnosis and twenty health subjects were evaluated. We proposed to evaluate Electrophysiological and Image techniques like markers in ALS diagnosis and correlate these results. Some research also report degeneration in no motor structures of the brain. Amyotrophic Lateral Sclerosis (ALS) is an uncommon illness, it is caused by moto neuron degeneration, upper, lower and bulbar muscles are affected.
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