Diagnostic Value of the Motor Band Sign in Amyotrophic Lateral Sclerosis: A 7T Magnetic Resonance Imaging Study
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Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease affecting both upper and lower motor neurons, with a median survival of 3–5 years [1]. The key challenge in diagnosis lies in the early detection of upper motor neuron (UMN) impairment, which mainly depends on clinical examination but can be obscured by severe lower motor neuron (LMN) impairment [2]. Consequently, searching for alternative UMN impairment markers has become a critical focus of ALS research. Recent magnetic resonance imaging (MRI) studies indicated a band-shaped low signal intensity along the primary motor cortex (M1), termed the motor band sign (MBS) [3]. MBS has emerged as an imaging marker for identifying UMN impairment in ALS [2, 4, 5]. Researchers believe this hypointensity results from ferritin accumulation within activated microglia in M1 [6]. SWI has demonstrated increased sensitivity in detecting subtle, uniformly distributed iron deposits, becoming the current mainstream modality for identifying MBS. However, there is currently a lack of reports of MBS in 7T SWI.
