Monitoring Progression of Amyotrophic Lateral Sclerosis Using Ultrasound Morpho-Textural Muscle Biomarkers: A Pilot Study

Ultrasound Med Biol. 2018 Jan;44(1):102-109. doi: 10.1016/j.ultrasmedbio.2017.09.013. Epub 2017 Oct 31.


The need is increasing for progression biomarkers that allow the loss of motor neurons in amyotrophic lateral sclerosis (ALS) to be monitored in clinical trials. In this prospective longitudinal study, muscle thickness, echointensity, echovariation and gray level co-occurrence matrix textural features are examined as possible progression ultrasound biomarkers in ALS patients during a 5-mo follow-up period. We subjected 13 patients to 3 measurements for 20 wk. They showed a significant loss of muscle, an evident tendency to loss of thickness and increased echointensity and echovariation. In regard to textural parameters, muscle heterogeneity tended to increase as a result of the neoformation of non-contractile tissue through denervation. Considering some limitations of the study, the quantitative muscle ultrasound biomarkers evaluated showed a promising ability to monitor patients affected by ALS.

Keywords: Amyotrophic lateral sclerosis; Biomarkers; Disease progression; Image processing computer-assisted; Motor neuron disease; Neuromuscular diseases; Ultrasonography.

MeSH terms

  • Aged
  • Amyotrophic Lateral Sclerosis / diagnostic imaging*
  • Biomarkers
  • Disease Progression*
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Muscle, Skeletal / diagnostic imaging*
  • Pilot Projects
  • Prospective Studies
  • Ultrasonography / methods*


  • Biomarkers