Journal
NEUROIMAGE-CLINICAL
Volume 4, Issue -, Pages 436-443Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.nicl.2014.02.011
Keywords
Amyotrophic lateral sclerosis; Biomarker; MRI; PET; Spectroscopy
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Funding
- Elan Fellowship in Neurodegeneration
- Health Research Board (HRB-Ireland)
- European Community's Seventh Framework Programme (FP7) [259867]
- EU-Joint Programme For Neurodegeneration (JPND) SOPHIA project
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Background: While neuroimaging in ALS has gained unprecedented momentum in recent years, little progress has been made in the development of viable diagnostic, prognostic and monitoring markers. Objectives: To identify and discuss the common pitfalls in ALS imaging studies and to reflect on optimal study designs based on pioneering studies. Methods: A PubMed-based literature search on ALS was performed based on neuroimaging-related keywords. Study limitations were systematically reviewed and classified so that stereotypical trends could be identified. Results: Common shortcomings, such as relatively small sample sizes, statistically underpowered study designs, lack of disease controls, poorly characterised patient cohorts and a large number of conflicting studies, remain a significant challenge to the field. Imaging data of ALS continue to be interpreted at a group-level, as opposed to meaningful individual-patient inferences. Conclusions: A systematic, critical review of ALS imaging has identified stereotypical shortcomings, the lessons of which should be considered in the design of future prospective MRI studies. At a time when large multicentre studies are underway a candid discussion of these factors is particularly timely. (C) 2014 The Authors. Published by Elsevier Inc.
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