Asymmetric white matter degeneration in amyotrophic lateral sclerosis: a diffusion kurtosis imaging study of motor and extra-motor pathways

This study explores DKI as a potential biomarker for ALS pathology, revealing microstructural changes in both motor and extra-motor pathways. Using whole-brain TBSS analysis and tractography with DIPY, we identified an asymmetric pattern of degeneration and involvement of integrative neural networks, providing new insights into ALS pathophysiology. These findings contribute to our understanding of the complex structural alterations in ALS and suggest that DKI-derived metrics may have utility in characterizing the disease process.