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WHAT TO KNOW ABOUT AMYOTROPHIC LATERAL SCLEROSIS MRI

Medically reviewed by Alana Biggers, M.D., MPH — Written by Adam Rowden on
November 29, 2024
* Before ALS MRI
* During ALS MRI
* After ALS MRI
* Other diagnostic tests
* ALS treatment
* Summary

MRI is a diagnostic test that doctors use to diagnose and track the progress of
amyotrophic lateral sclerosis (ALS).

ALS is a progressive disease that damages nerve cells in the brain and spinal
cord. Over time, the condition causes a person to lose the ability to use their
muscles, hindering their ability to walk, talk, and breathe.

MRI is an imaging technology that uses magnetic fields and radio waves to create
3D detailed anatomical images of tissues and organs inside the body.

This article outlines what to expect before, during, and after a brain MRI scan
for ALS diagnosis. It also discusses other diagnostic tests and possible
treatments for ALS.

WHAT TO EXPECT BEFORE ALS MRI

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Before an MRI scan, a person will change into a hospital gown. This helps
prevent artifacts from showing up on the final images. Artifacts are
imperfections or distortions that do not feature in the live image.

The guidelines for eating and drinking before an MRI scan can vary depending on
the exam type. A person needs to discuss this with their doctor beforehand so
they know which steps to take.

They also need to take medications as usual, unless the doctor has asked them
otherwise.

In some cases, an MRI scan may require an intravenous injection of a contrast
material. Contrast materials are substances that temporarily change the way
imaging tools interact with parts of the body.

If a scan does use a contrast material, the imaging center staff will ask the
person if they are allergic to these substances.

WHAT TO EXPECT DURING ALS MRI

During an MRI scan, a person will have to lie down on a moveable exam table. The
healthcare professional carrying out the scan may use straps to help maintain
the person’s position.

They will then place a device around the person’s head. This device fits like a
helmet and is known as the brain MRI coil, which helps create detailed images of
the brain.

If the exam involves a contrast material, a medical professional will inject the
material into the person’s body through an intravenous catheter.

The person will then move into the magnet section of the MRI machine, and the
scan will begin.

The medical professional performing the scan will sit outside the room during
the exam. The individual undergoing the scan will be able to talk with the
medical professional during the scan via an intercom machine.

During the exam, the person may hear some loud noises as the MRI machine works.
They may also experience slight warmth during the scan.

WHAT WILL A HEALTHCARE PROFESSIONAL BE LOOKING FOR ON THE MRI SCAN?

During an MRI scan, a healthcare professional may look forTrusted Source upper
motor neuron (UMN) degeneration. This can signify that ALS is present.

Brain MRI scans can monitor UMN degeneration before a person develops clinical
symptoms of ALS. This means that MRI scans may be useful in helping diagnose ALS
and track its progression.

A procedure called 1H-MRS can also help doctors see certain biomarkers specific
to ALS. This can help them make a diagnosis. 1H-MRS is a noninvasive imaging
method for assessingTrusted Source microscopic neurological abnormalities.

Healthcare professionals may also use MRI scans to rule outTrusted Source other
possible causes of ALS symptoms.

WHAT TO EXPECT AFTER ALS MRI

If a person does not undergo sedation during their MRI scan, they will usually
have no recovery period. This means they can resume their usual activities and
eat their typical diet after the procedure.

In some rare cases, a person may experience side effects from the contrast
material. These side effects include:

* nausea
* headaches
* pain at the injection site

If a person experiences an allergic reaction to the contrast material, they need
to tell their doctor or radiologist. Possible signs of an allergic reaction
include hives and itchy eyes.

The scan results will usually take 1 to 2 weeks to arrive, according to the
United Kingdom’s National Health Service (NHS). However, if the results are more
urgent, they may arrive more quickly.

OTHER DIAGNOSTIC TESTS

There is no singleTrusted Source diagnostic test that can fully diagnose ALS.

When diagnosing the condition, a doctor will often carry out a physical exam and
review the person’s medical history.

During the physical exam, they may test the individual’s:

* reflexes
* muscle strength
* responses

They may then carry out an electromyography (EMG) test to rule out other
diseases and support their ALS diagnosis. An EMG test evaluates how well a
person’s muscles and nerves function.

During an EMG, a healthcare professional may carry out a needle exam and nerve
conditioning studies (NCS). Needle exams involve using an electrode to detect
electrical activity in muscle fibers. An NCS assesses the nerve’s ability to
send signals by measuring the electrical activity of nerves and muscles.

Doctors may also recommend a spinal tap or a muscle biopsy if other test results
indicate a person may have ALS.

ALS TREATMENT

There is no cureTrusted Source for ALS. Current ALS treatments aim to slow the
disease’s progression and may increase a person’s survival rate. They also aim
to improve quality of life.

Treatments that the FDA has approved for treating ALS include:

* Edaravone: Edaravone is a type of antioxidant that can help slow the
functional decline in people with ALS.
* Riluzole: Riluzole can reduce the levels of glutamate in the brain. Glutamate
plays a role in carrying messages between nerve cells and motor neurons. By
reducing these levels, riluzole can reduce damage to motor neurons.
* Tofersen: This new medication helps decrease one of the markers of damage to
neurons. However, more studies are necessary to determine the efficacy of
this treatment for people with ALS.

The FDA approved the use of sodium phenylbutyrate/taurursodiol in 2022. This
medication helps block stress signals in cells, which researchers believe may
help prevent nerve death in people with ALS.

However, the manufacturer removed the drug from the market in 2024 after a large
clinical trial failed to confirm findings from previous trials into its
efficacy.

SUMMARY

Brain MRI scans can help medical professionals diagnose and track the progress
of amyotrophic lateral sclerosis (ALS). They can also use MRI scans to rule out
other causes of symptoms.

During an MRI scan, doctors may look for upper motor neuron (UMN)
degenerationTrusted Source, which can signify that ALS is present.

Other diagnostic tests for ALS include physical exams, electromyography (EMG)
tests, spinal taps, and muscle biopsies.

* MRI / PET / Ultrasound
* Muscular Dystrophy / ALS

HOW WE REVIEWED THIS ARTICLE:

Sources
Medical News Today has strict sourcing guidelines and relies on peer-reviewed
studies, academic research institutions, and medical journals and associations.
We only use quality, credible sources to ensure content accuracy and integrity.
You can learn more about how we ensure our content is accurate and current by
reading our editorial policy.
* Amyotrophic lateral sclerosis (ALS). (2024).
https://www.ninds.nih.gov/health-information/disorders/amyotrophic-lateral-sclerosis-als
* Brain MRI. (2024).
https://www.radiologyinfo.org/en/info/mri-brain
* Caldwell S, et al. (2021). 1H magnetic resonance spectroscopy to understand
the biological basis of ALS, diagnose patients earlier, and monitor disease
progression.
https://pubmed.ncbi.nlm.nih.gov/34512519/
* Contrast materials. (2024).
https://www.radiologyinfo.org/en/info/safety-contrast
* Igarashi H, et al. (2021). Proton magnetic resonance spectroscopy (1H-MRS).
https://pubmed.ncbi.nlm.nih.gov/33762470/
* MRI scan - How it’s performed. (2022).
https://www.nhs.uk/conditions/mri-scan/what-happens/
* Nitert AD, et al. (2022). Sensitivity of brain MRI and neurological
examination for detection of upper motor neurone degeneration in amyotrophic
lateral sclerosis.
https://pubmed.ncbi.nlm.nih.gov/34663622/

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Medically reviewed by Alana Biggers, M.D., MPH — Written by Adam Rowden on
November 29, 2024

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