Visualization of Gray Matter Atrophy and Anterior Corticospinal Tract Signal Hyperintensity in Amyotrophic Lateral Sclerosis Using 7T MRI

Two patients with amyotrophic lateral sclerosis (ALS) presenting different phenotypic descriptions underwent 7T MRI examination: a man left upper limb amyotrophy due to lower motor neuron–predominant ALS (ALS Functional Rating Scale [ALSFRS] 33/48, Medical Research Council [ULMRC] scale 15/25, right ULMRC 25/25, neurons [UMNs] score 17/55), in whom anterior gray matter hemiatrophy could be seen (figure, A); and woman spastic tetraparesis UMN-predominant (ALSFRS 34/48, 21/25, UMNs 55/55) exhibiting corticospinal but also tracts hyperintensities B), while posterior sensory were preserved. Consistent respective clinical features, line recent reports,1,2 these imaging findings open perspectives for white matter/gray impairment description at 7T.