Cortical atrophy, as assessed by novel volumetric MRI techniques, have revealed inconsistent results in ALS.  Specifically, while cortical thinning, predominantly within the motor/frontal lobe regions, have been reported by some, absence of atrophy has been reported by others.  Mioshi and colleagues elegantly demonstrate a potential explanation for such discordant MRI findings.  Namely, ALS patients with cognitive dysfunction exhibit abnormalities within the motor and somatosensory areas  while pure ALS patients have normal MRI findings.

Could this be of diagnostic or event therapeutic significance in ALS?  Perhaps!!

Mioshi E, Lillo P, Yew B, Hsieh S, Savage S, Hodges JR, Kiernan MC, Hornberger M. Cortical atrophy in ALS is critically associated with neuropsychiatric and cognitive changes. Neurology. 2013 19;80:1117-23.