TY  - JOUR
AU  - Kassubek, Jan
AU  - Roselli, Francesco
AU  - Witzel, Simon
AU  - Dorst, Johannes
AU  - Ludolph, Albert C
AU  - Rasche, Volker
AU  - Vernikouskaya, Ina
AU  - Müller, Hans-Peter
TI  - Hypothalamic atrophy in primary lateral sclerosis, assessed by convolutional neural network-based automatic segmentation.
JO  - Scientific reports
VL  - 15
IS  - 1
SN  - 2045-2322
CY  - [London]
PB  - Springer Nature
M1  - DZNE-2025-00113
SP  - 1551
PY  - 2025
AB  - Primary lateral sclerosis (PLS) is a motor neuron disease (MND) which mainly affects upper motor neurons. Within the MND spectrum, PLS is much more slowly progressive than amyotrophic laterals sclerosis (ALS). `Classical` ALS is characterized by catabolism and abnormal energy metabolism preceding onset of motor symptoms, and previous studies indicated that the disease progression of ALS involves hypothalamic atrophy. Very limited weight loss is observed in patients with PLS, which raises the question of whether there are also less hypothalamic alterations. The purpose of this study was to quantitatively investigate the hypothalamic volume in a group of PLS patients and to compare it with ALS and controls. Recently, we have introduced automatic hypothalamic quantification method based on the use of convolutional neural network (CNN) to reduce human variability and enhance analysis robustness. This CNN of U-Net architecture was applied for automatic segmentation of the hypothalamus and intracranial volume (ICV) to allow adjustments of the hypothalamic volume between subjects with different head sizes respectively. Automatic segmentation and volumetric analysis were performed in high resolution T1 weighted MRI volumes (acquired on a 1.5 T MRI scanner) of 46 PLS patients in comparison to 107 healthy controls and 411 `classical` ALS patients, respectively. Significant hypothalamic volume reduction was observed in PLS (818 ± 73 mm3) when compared to controls (852 ± 77 mm3); significant hypothalamic volume reduction was also confirmed in ALS (823 ± 84 mm3), in support of previous studies. No significant differences were found in normalized hypothalamic volumes between ALS patients and PLS patients at the group level. This unbiased CNN-based hypothalamus volume quantification study demonstrated similarly reduced hypothalamus volume in PLS and ALS patients, despite the clinical phenotypic differences.
KW  - Humans
KW  - Female
KW  - Male
KW  - Hypothalamus: pathology
KW  - Hypothalamus: diagnostic imaging
KW  - Middle Aged
KW  - Neural Networks, Computer
KW  - Magnetic Resonance Imaging: methods
KW  - Atrophy: pathology
KW  - Aged
KW  - Amyotrophic Lateral Sclerosis: pathology
KW  - Amyotrophic Lateral Sclerosis: diagnostic imaging
KW  - Adult
KW  - Motor Neuron Disease: pathology
KW  - Motor Neuron Disease: diagnostic imaging
KW  - Image Processing, Computer-Assisted: methods
KW  - Case-Control Studies
KW  - Amyotrophic Lateral Sclerosis (Other)
KW  - Hypothalamus (Other)
KW  - Magnetic Resonance Imaging (Other)
KW  - Metabolism (Other)
KW  - Neuronal Networks (Other)
KW  - Primary Lateral Sclerosis (Other)
KW  - Volumetry (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:39789167
C2  - pmc:PMC11718091
DO  - DOI:10.1038/s41598-025-85786-6
UR  - https://pub.dzne.de/record/275878
ER  -