Combined cerebral and spinal cord functional imaging in amyotrophic lateral sclerosis

• Applicant: Dr. Robert Schulz
• Subject Area: Clinical Neurology; Neurosurgery and Neuroradiology
• Term: since 2025
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 566776152

Amyotrophic lateral sclerosis (ALS) is a progressive, neurodegenerative disease that mainly affects the motor neurons of the cerebral cortex, brainstem, and spinal cord. Imaging studies have primarily focused on changes in functional and structural brain networks and have related these changes to clinical deficits and disease progression. The spinal cord and the lower motor neurons located there have been excluded from previous functional MRI studies due to technical limitations. However, recent technological advancements now allow for simultaneous measurement of cerebral and spinal cord task-related activations, enabling the investigation of corticospinal coupling during motor tasks. Using combined corticospinal functional MRI during a simple motor task with the upper limb in ALS patients and healthy participants, this project aims to systematically examine changes in spinal activation and functional coupling with key motor areas of the brain, such as the primary motor cortex in ALS patients. The analyses will focus on comparing spinal activation and corticospinal coupling between ALS patients and healthy controls, mapping the exact topography of spinal activation and coupling, integrating structural properties of important motor networks and pathways like the corticospinal tract, incorporating electrophysiological markers of spinal neurodegeneration, analyzing changes in spinal activation and coupling over the first 12 months of the study, and most importantly investigating the relationship between spinal activation, coupling data, and clinical deficits and disease progression over two years. Through its multimodal approach combining innovative functional and structural imaging of the motor system spanning from the cortex to the spinal lower motor neurons, along with electrophysiology and comprehensive clinical data from patients over two years, this study aims to fill a relevant knowledge gap in imaging ALS research and help develop new imaging-based biomarkers to understand variability in phenotype and disease progression better.

• DFG Programme: Research Grants