Multimodal whole-body muscle MRI in ALS, including artificial intelligence (AI)-assisted image processing: Biomarker of lower motor neuron dysfunction

A major challenge in ALS research is the lack of effective biomarkers that help us to monitor the disease as it progresses. A reliable measure of ALS progression has the potential to significantly strengthen the ability to detect positive treatment effects in clinical trials.

In this project, Dr. Breiner and Dr. Warman-Chardon aim to address this gap by using advanced whole‑body muscle MRI, combined with electrical impedance myography (EIM), to create a more accurate picture of muscle health in people living with ALS. Unlike traditional MRI scans, which mainly focus on the brain or spinal cord, this approach looks directly at the muscles themselves to detect early changes caused by lower motor neuron damage.

The research team will follow 40 people living with ALS and 20 healthy volunteers over six months. By tracking muscle changes over time, they hope to identify patterns showing how ALS spreads through the body and which muscles may be affected before symptoms appear. A key innovation in this study is the use of artificial intelligence (AI) to help analyze the large number of muscle images. In addition to the potential to track disease progression, the team is examining the ability of these biomarkers to support earlier diagnosis and improve our current capabilities to determine how fast the disease will progress (prognosis).

The project will also develop a shared imaging platform called MYO‑Share, allowing researchers worldwide to collaborate and accelerate future discoveries.

Dr. Ari Breiner completed his medical studies at McGill University in 2005 and Neurology residency at both McGill University and the University of Toronto.  After EMG/Neuromuscular fellowships at Columbia University and the University of Toronto, he pursued a Master’s degree in Clinical Epidemiology and Health Care Research.  He is involved in the clinical care of patients with ALS, myasthenia gravis, and does EMG studies at the Civic campus.  He currently holds the Éric Poulin Chair for ALS Clinical Research at the University of Ottawa.  He is also the principal investigator for several clinical research studies in ALS and myasthenia gravis.

Dr. Breiner is the current chair of the Canadian ALS Research Network (CALS).

Dr Jodi Warman-Chardon is a Clinician-Scientist in the Department of Medicine at the Ottawa Hospital, Ottawa Hospital Research Institute (OHRI) in Neurosciences and Clinical Epidemiology and Department of Genetics at the Children’s Hospital of Eastern Ontario/CHEO RI. She holds the Clinical Research Chair in Diagnosis and Discovery Pipeline for Patients with Genetic Neuromuscular Disease (NMD) at the University of Ottawa. Dr Warman received her MD/Neurology residency at the University of Ottawa and PhD from McGill University. She completed research and clinical fellowships in NMD and neurogenetics and is certified by the Canadian Society of Clinical Neurophysiologists (EMG). She led the strategic development and is now Director of the Ottawa Hospital Neuromuscular Centre, a diagnostic clinical research centre for patients with NMD. Dr. Warman-Chardon’s research program and clinical practice focuses on the diagnosis and the clinical characterization of patients with rare or novel nerve and muscle disorders with genomics technologies and muscle magnetic resonance imaging (MRI). In addition, she is focused on assessing and improving the social determinants of health for people living with neuromuscular disease and amyotrophic lateral sclerosis.

The ALS Canada Research Program is committed to advancing clinical management research. We aim to support work that improves the discovery of biomarkers, enhances patient care, and deepens our understanding of ALS progression and disease management.