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The following is a summary of “An Investigation of Corticospinal Tract Microstructural Integrity in ARSACS Using a Profilometry MRI Analysis: Results From the PROSPAX Study,” published in the April 2025 issue of European Journal of Neurology by Scaravilli et al. 

Spasticity is a key symptom in patients with autosomal recessive spastic ataxia of charlevoix-saguenay (ARSACS), but its underlying mechanisms remain unclear. This study investigates the microstructure of the corticospinal tract (CST) using diffusion MRI (dMRI) profilometry. 

Researchers conducted a retrospective study to assess CST microstructure in ARSACS using dMRI profilometry. Spasticity was linked to spatially defined CST damage near thickened pons. 

They analyzed data from 37 patients with ARSACS (M/F = 21/16; 33.4 ± 12.4 years) and 29 controls (M/F = 13/16; 42.1 ± 17.2 years) collected between January 2021 and October 2022. They assessed CST microstructural integrity and its spatial damage pattern using profilometry and tested correlations with clinical severity, including spastic paraplegia rating scale (SPRS). 

The results showed significant CST involvement in ARSACS versus controls (P < 0.001), with greater damage above and below the thickened pons (P < 0.001). A bilateral negative correlation was found between CST integrity and SPRS scores (P = 0.02 for both sides). 

Investigators found clinically meaningful CST microstructural involvement in ARSACS, with damage above and below a thickened pons. They suggested CST microstructure evaluation as a potential biomarker. 

Source: onlinelibrary.wiley.com/doi/full/10.1111/ene.70128