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Various classification frameworks have been proposed for amyotrophic lateral sclerosis (ALS), a disease with substantial phenotypic heterogeneity. To determine anatomic patterns of disease without prior clinical stratification, researchers measured cortical thickness and white-matter connectome fractional anisotropy on magnetic resonance imaging (MRI) T1-weighted and diffusion tensor imaging. Clinical and cognitive tests and MRI scans were performed on 488 patients with ALS and 338 healthy control subjects. More than half of ALS participants underwent repeat MRI scanning at 3 to 6 months. Patients with swallowing or respiratory difficulty while supine were excluded.
Using a probabilistic network-based clustering algorithm, the researchers id…