Diffusion tensor imaging in the diagnosis of primary lateral sclerosis

PURPOSE: To evaluate the utility of MR diffusion tensor imaging in diagnosing primary lateral sclerosis (PLS). MATERIALS AND METHODS: Five patients who met clinical criteria for a diagnosis of PLS, and two patients with possible PLS of less than three years duration and eight normal volunteers were studied using MR diffusion tensor imaging. RESULTS: All seven patients showed decreased diffusion anisotropy and increased diffusion constant in the PLIC, with complete separation from a normal control group, including patients early in the course of the illness. CONCLUSION: Quantitative diffusion tensor imaging appears to be a useful test to detect upper motor neuron damage and hence to help to establish the diagnosis of PLS.