{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T05:26:44Z","timestamp":1762320404044,"version":"build-2065373602"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Scientific Research Incubation Fund of Shandong Provincial Hospital","award":["2024FY135"],"award-info":[{"award-number":["2024FY135"]}]},{"name":"Jinan Clinical Research Center for Neurological Disease Imaging Monitoring","award":["201912004"],"award-info":[{"award-number":["201912004"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol Exp"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease with peripheral nerve involvement, but current diagnostics are limited. Diffusion tensor imaging (DTI) may improve microstructural assessment and correlate with clinical markers. We investigated the diffusion properties of the brachial plexus in ALS and examined their relationships with electrophysiological parameters of upper limb nerves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We enrolled 25 ALS patients and 22 age- and sex-matched healthy controls. DTI of the brachial plexus was conducted to measure fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). Differences in DTI parameters between the two groups were analyzed. Correlations between DTI parameters and ALS Functional Rating Scale-Revised (ALSFRS-R) scores, along with electrophysiological measurements, were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In ALS patients compared to controls, FA and AD values were significantly lower (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.002), while the RD value was significantly higher (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). There were no statistically significant differences in MD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.540). Both FA and AD showed a positive correlation with ALSFRS-R score, ALSFRS-upper limb score, and compound muscle action potential amplitude of median, ulnar, and radial nerves (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009\u2265\u20090.480;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.015). The RD values showed a negative correlation with ALSFRS-upper limb score and motor nerve conduction velocity of median, ulnar, and radial nerves (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009\u2264\u2009-0.415;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.039).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>FA, AD, and RD values of DTI showed the potential to identify microstructural changes in the brachial plexus nerve roots of ALS patients and may serve as potential indicators of nerve conduction function in the upper extremities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance statement<\/jats:title>\n                    <jats:p>DTI may reveal microstructural changes in ALS brachial plexus, correlating with nerve dysfunction, offering novel biomarkers for evaluation of upper limb neurodegeneration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Lower Fractional anisotropy (FA) and axial diffusivity (AD), and higher radial diffusivity (RD) were shown in amyotrophic lateral sclerosis (ALS) brachial plexus.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Diffusion tensor imaging (DTI) parameters correlated with clinical and electrophysiological parameters.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>FA, AD, and RD detected ALS nerve microstructural changes, indicating abnormal conduction function.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s41747-025-00645-3","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T16:31:56Z","timestamp":1762273916000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["DTI changes of brachial plexus nerve roots in amyotrophic lateral sclerosis and their correlation with electrophysiology"],"prefix":"10.1186","volume":"9","author":[{"given":"Shanshan","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuxin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuewen","family":"Xing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao","family":"Man","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yufan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7410-5540","authenticated-orcid":false,"given":"Guangbin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"645_CR1","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1016\/S0140-6736(22)01272-7","volume":"400","author":"EL Feldman","year":"2022","unstructured":"Feldman EL, Goutman SA, Petri S et al (2022) Amyotrophic lateral sclerosis. Lancet 400:1363\u20131380. https:\/\/doi.org\/10.1016\/S0140-6736(22)01272-7","journal-title":"Lancet"},{"key":"645_CR2","doi-asserted-by":"publisher","first-page":"1502","DOI":"10.1007\/s12035-021-02658-6","volume":"59","author":"S Verma","year":"2022","unstructured":"Verma S, Khurana S, Vats A et al (2022) Neuromuscular junction dysfunction in amyotrophic lateral Sclerosis. Mol Neurobiol 59:1502\u20131527. https:\/\/doi.org\/10.1007\/s12035-021-02658-6","journal-title":"Mol Neurobiol"},{"key":"645_CR3","doi-asserted-by":"publisher","DOI":"10.1186\/1742-2094-7-8","volume":"7","author":"DJ Graber","year":"2010","unstructured":"Graber DJ, Hickey WF, Harris BT (2010) Progressive changes in microglia and macrophages in spinal cord and peripheral nerve in the transgenic rat model of amyotrophic lateral sclerosis. J Neuroinflammation 7:8. https:\/\/doi.org\/10.1186\/1742-2094-7-8","journal-title":"J Neuroinflammation"},{"key":"645_CR4","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1016\/j.expneurol.2003.10.004","volume":"185","author":"LR Fischer","year":"2004","unstructured":"Fischer LR, Culver DG, Tennant P et al (2004) Amyotrophic lateral sclerosis is a distal axonopathy: evidence in mice and man. Exp Neurol 185:232\u2013240. https:\/\/doi.org\/10.1016\/j.expneurol.2003.10.004","journal-title":"Exp Neurol"},{"key":"645_CR5","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1080\/146608200300079536","volume":"1","author":"BR Brooks","year":"2000","unstructured":"Brooks BR, Miller RG, Swash M, Munsat TL, World Federation of Neurology Research Group on Motor Neuron D (2000) El Escorial revisited: revised criteria for the diagnosis of amyotrophic lateral sclerosis. Amyotroph Lateral Scler Other Motor Neuron Disord 1:293\u2013299. https:\/\/doi.org\/10.1080\/146608200300079536","journal-title":"Amyotroph Lateral Scler Other Motor Neuron Disord"},{"key":"645_CR6","doi-asserted-by":"publisher","first-page":"453","DOI":"10.3109\/21678421.2014.903974","volume":"15","author":"S Paganoni","year":"2014","unstructured":"Paganoni S, Macklin EA, Lee A et al (2014) Diagnostic timelines and delays in diagnosing amyotrophic lateral sclerosis (ALS). Amyotroph Lateral Scler Frontotemporal Degener 15:453\u2013456. https:\/\/doi.org\/10.3109\/21678421.2014.903974","journal-title":"Amyotroph Lateral Scler Frontotemporal Degener"},{"key":"645_CR7","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1002\/jmri.28125","volume":"56","author":"ET Tan","year":"2022","unstructured":"Tan ET, Serrano KC, Bhatti P et al (2022) Quantitative MRI differentiates electromyography severity grades of denervated muscle in neuropathy of the brachial plexus. J Magn Reson Imaging 56:1104\u20131115. https:\/\/doi.org\/10.1002\/jmri.28125","journal-title":"J Magn Reson Imaging"},{"key":"645_CR8","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1148\/radiol.2015150559","volume":"279","author":"S Gerevini","year":"2016","unstructured":"Gerevini S, Agosta F, Riva N et al (2016) MR imaging of brachial plexus and limb-girdle muscles in patients with amyotrophic lateral sclerosis. Radiology 279:553\u2013561. https:\/\/doi.org\/10.1148\/radiol.2015150559","journal-title":"Radiology"},{"key":"645_CR9","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1002\/jmri.29027","volume":"60","author":"W Liang","year":"2024","unstructured":"Liang W, Liu Y, Zhao Y et al (2024) Quantitative MRI analysis of brachial plexus and limb-girdle muscles in upper extremity onset amyotrophic lateral sclerosis. J Magn Reson Imaging 60:291\u2013301. https:\/\/doi.org\/10.1002\/jmri.29027","journal-title":"J Magn Reson Imaging"},{"key":"645_CR10","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/j.nec.2010.12.004","volume":"22","author":"LJ O\u2019Donnell","year":"2011","unstructured":"O\u2019Donnell LJ, Westin CF (2011) An introduction to diffusion tensor image analysis. Neurosurg Clin N Am 22:185\u2013196. https:\/\/doi.org\/10.1016\/j.nec.2010.12.004. viii","journal-title":"Neurosurg Clin N Am"},{"key":"645_CR11","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1055\/s-0043-1775742","volume":"27","author":"D Yoon","year":"2023","unstructured":"Yoon D, Lutz AM (2023) Diffusion tensor imaging of peripheral nerves: current status and new developments. Semin Musculoskelet Radiol 27:641\u2013648. https:\/\/doi.org\/10.1055\/s-0043-1775742","journal-title":"Semin Musculoskelet Radiol"},{"key":"645_CR12","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1002\/jmri.25056","volume":"43","author":"NG Simon","year":"2016","unstructured":"Simon NG, Lagopoulos J, Gallagher T, Kliot M, Kiernan MC (2016) Peripheral nerve diffusion tensor imaging is reliable and reproducible. J Magn Reson Imaging 43:962\u2013969. https:\/\/doi.org\/10.1002\/jmri.25056","journal-title":"J Magn Reson Imaging"},{"key":"645_CR13","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1097\/RLI.0000000000000156","volume":"50","author":"MO Breckwoldt","year":"2015","unstructured":"Breckwoldt MO, Stock C, Xia A et al (2015) Diffusion tensor imaging adds diagnostic accuracy in magnetic resonance neurography. Invest Radiol 50:498\u2013504. https:\/\/doi.org\/10.1097\/RLI.0000000000000156","journal-title":"Invest Radiol"},{"key":"645_CR14","unstructured":"David C, Preston BES (2020) Electromyography and neuromuscular disorders: clinical-electrophysiologic-ultrasound correlations. Elsevier, New York"},{"key":"645_CR15","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s41747-024-00444-2","volume":"8","author":"O Foesleitner","year":"2024","unstructured":"Foesleitner O, Sulaj A, Sturm V et al (2024) Diffusion tensor imaging in anisotropic tissues: application of reduced gradient vector schemes in peripheral nerves. Eur Radiol Exp 8:37. https:\/\/doi.org\/10.1186\/s41747-024-00444-2","journal-title":"Eur Radiol Exp"},{"key":"645_CR16","doi-asserted-by":"publisher","first-page":"882","DOI":"10.1007\/s00415-017-8443-x","volume":"264","author":"NG Simon","year":"2017","unstructured":"Simon NG, Lagopoulos J, Paling S et al (2017) Peripheral nerve diffusion tensor imaging as a measure of disease progression in ALS. J Neurol 264:882\u2013890. https:\/\/doi.org\/10.1007\/s00415-017-8443-x","journal-title":"J Neurol"},{"key":"645_CR17","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/0022-510x(81)90153-2","volume":"50","author":"G Sobue","year":"1981","unstructured":"Sobue G, Matsuoka Y, Mukai E, Takayanagi T, Sobue I (1981) Pathology of myelinated fibers in cervical and lumbar ventral spinal roots in amyotrophic lateral sclerosis. J Neurol Sci 50:413\u2013421. https:\/\/doi.org\/10.1016\/0022-510x(81)90153-2","journal-title":"J Neurol Sci"},{"key":"645_CR18","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1097\/NEN.0000000000000081","volume":"73","author":"N Riva","year":"2014","unstructured":"Riva N, Chaabane L, Peviani M et al (2014) Defining peripheral nervous system dysfunction in the SOD-1G93A transgenic rat model of amyotrophic lateral sclerosis. J Neuropathol Exp Neurol 73:658\u2013670. https:\/\/doi.org\/10.1097\/NEN.0000000000000081","journal-title":"J Neuropathol Exp Neurol"},{"key":"645_CR19","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1002\/jmri.25876","volume":"47","author":"T Jeon","year":"2018","unstructured":"Jeon T, Fung MM, Koch KM, Tan ET, Sneag DB (2018) Peripheral nerve diffusion tensor imaging: overview, pitfalls, and future directions. J Magn Reson Imaging 47:1171\u20131189. https:\/\/doi.org\/10.1002\/jmri.25876","journal-title":"J Magn Reson Imaging"},{"key":"645_CR20","doi-asserted-by":"publisher","first-page":"S175","DOI":"10.1016\/j.acra.2021.08.006","volume":"29","author":"F Wu","year":"2022","unstructured":"Wu F, Ren Y, Wang W et al (2022) Microstructural alteration of lumbosacral nerve roots in chronic inflammatory demyelinating polyradiculoneuropathy: insights from DTI and correlations with electrophysiological parameters. Acad Radiol 29:S175\u2013S182. https:\/\/doi.org\/10.1016\/j.acra.2021.08.006","journal-title":"Acad Radiol"},{"key":"645_CR21","doi-asserted-by":"publisher","unstructured":"Traiffort E, Morisset-Lopez S, Moussaed M, Zahaf A (2021) Defective oligodendroglial lineage and demyelination in amyotrophic lateral sclerosis. Int J Mol Sci 22. https:\/\/doi.org\/10.3390\/ijms22073426","DOI":"10.3390\/ijms22073426"},{"key":"645_CR22","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1007\/s00256-010-0974-5","volume":"39","author":"S Jambawalikar","year":"2010","unstructured":"Jambawalikar S, Baum J, Button T et al (2010) Diffusion tensor imaging of peripheral nerves. Skeletal Radiol 39:1073\u20131079. https:\/\/doi.org\/10.1007\/s00256-010-0974-5","journal-title":"Skeletal Radiol"},{"key":"645_CR23","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.neurad.2021.05.004","volume":"49","author":"MJ Ho","year":"2022","unstructured":"Ho MJ, Held U, Steigmiller K et al (2022) Comparison of electrodiagnosis, neurosonography and MR neurography in localization of ulnar neuropathy at the elbow. J Neuroradiol 49:9\u201316. https:\/\/doi.org\/10.1016\/j.neurad.2021.05.004","journal-title":"J Neuroradiol"}],"container-title":["European Radiology Experimental"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41747-025-00645-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s41747-025-00645-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41747-025-00645-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T05:07:56Z","timestamp":1762319276000},"score":1,"resource":{"primary":{"URL":"https:\/\/eurradiolexp.springeropen.com\/articles\/10.1186\/s41747-025-00645-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,4]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["645"],"URL":"https:\/\/doi.org\/10.1186\/s41747-025-00645-3","relation":{},"ISSN":["2509-9280"],"issn-type":[{"type":"electronic","value":"2509-9280"}],"subject":[],"published":{"date-parts":[[2025,11,4]]},"assertion":[{"value":"6 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This prospective study was approved by the Institutional Ethics Committee of Shandong Provincial Hospital (Approval No. 2016-KY-061; Date: March 2016).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"107"}}