Amyotrophic Lateral Sclerosis (ALS) is a disease of the brain and spinal cord that destroys nerve cells and makes it hard to control your muscles.

The ability to move, talk, and eventually even breathe gets worse over time. There is no known cure, but researchers are testing methods to alleviate symptoms, including magnetic stimulation.

Now with the help of magnetoencephalography, researchers from the Human Brain Project (HBP) have found a new marker that can be used to predict the clinical outcome of Amyotrophic Lateral Sclerosis (ALS) patients.

This marker, which can be tested in the resting brain, demonstrates the significance of brain flexibility for ALS patients.

The study was led by the Institut de Neurosciences des Systèmes in Marseille, France, with help from the Consiglio Nazionale delle Ricerche, the Parthenope University of Naples, the Institute of Diagnosis and Care Hermitage Capodimonte in Naples, and the Monash University in Melbourne, Australia.

The study describing the results was published today in the journal Neurology.

ALS is a disease of the brain and spinal cord that destroys nerve cells and makes it hard for people to move their muscles.

The ability to move, talk, and eventually even breathe gets worse over time.

Although there is no known cure, medical professionals are testing various symptom-relieving measures, such as magnetic stimulation.

“The behaviour of the brain of an ALS patient,” as explained by one of the authors of the study Pierpaolo Sorrentino, “is often hard to understand. 

“The impairments can be caused by neuronal dysfunction of a small area of the brain that influences a much larger area, meaning you need whole brain scans to make predictions of the clinical outcome. Patients can struggle with motor tasks during the scans.

“This new method,” according to the author, “instead, can be applied to the brain at rest, making it easier for the patients and more consistent.”

The University Parthenope in Naples, whose MEG facilities have recently joined the EBRAINS network, provided the magnetoencephalography data on 42 ALS patients and 42 healthy controls.

This new research expands upon the same team’s earlier efforts to apply this strategy to Parkinson’s.

According to Sorrentino, a healthy brain is one that is flexible, and capable of rearranging itself to adapt to inputs, causing neuronal avalanches across multiple locations. 

“Think of it as a goalkeeper waiting for a penalty kick.

“If you are fast enough,” according to the author, “constantly moving rather than standing in the same place is a better strategy for being ready for most possible trajectories.”

“The neuronal avalanches spread in patterns which we can monitor with whole-brain scans,” adds lead author Arianna Polverino. 

“We call the collection of all unique patterns the ‘functional repertoire’, a measurement of the flexibility of the brain.” 

The researchers concentrated on assessing the functional repertoire of ALS brains even when the patient was unprompted and the brain was resting.

They “found that a restriction of the functional repertoire corresponded to a more severe functional impairment. The more flexible the brain, the better the clinical outcome: the functional repertoire can be used as a reliable predictor of how the clinical outlook of a patient will likely evolve.”

“It is often difficult to tell how a particular therapy is working – now we might have a strong marker to predict its outcome,” adds Sorrentino. 

According to the researchers, the next step is to use this non-invasive readout to a long-term study that analyzes the progression of the illness in a patient-specific manner and modifies therapy as necessary.

“The ultimate goal is to apply the predictive power of the functional repertoire in personalised medicine, perhaps extending the same approach to brain dynamics to other, large-scale applications,” ends Polverino.

Source: 10.1212/WNL.0000000000201200

Image Credit: Getty

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