| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Department of Clinical Neurosciences (C.M. Ellis and J.M. Dawson, and Drs. Simmons, Williams, and Leigh), Institute of Psychiatry and King's Healthcare, and the Neuroimaging Department (Drs. Simmons and Williams, and C. Andrews and J.M. Dawson), Maudsley Hospital, London, UK.
Address correspondence and reprint requests to Dr Ellis, Department of Clinical Neurosciences, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
Objective: To evaluate neuronal dysfunction in the motor region subcortical white matter in ALS using volumetric localized proton magnetic resonance spectroscopy (1H-MRS).
Methods: Sixteen patients with El Escorial definite, probable, or possible ALS and eight healthy age-matched control subjects were studied. The ALS patients were divided into those with limb onset (n = 8) and those with bulbar onset (n = 8). Measurements of the metabolic ratios N-acetylaspartate (NAA)/creatine and phosphocreatine (Cr+PCr), NAA/choline (Cho), and Cho/(Cr+PCr) were correlated with clinical assessments.
Results: We found no differences in the metabolic peak area ratios in the motor region when comparing the total ALS group and the control subjects. However, correlations were found between the NAA/(Cr+PCr) ratio and the El Escorial category (p = 0.03), the ALS severity scale (p = 0.01), and the Medical Research Council score (p = 0.06). No correlations were found between the NAA/(Cr+PCr) ratio and the Ashworth Spasticity Scale, reflex score, or disease duration (p > 0.16). Bulbar-onset patients had a lower NAA/(Cr+PCr) ratio in the motor region compared with limb-onset patients (p = 0.03).
Conclusion: In vivo 1H-MRS of the subcortical white matter in the motor region is unlikely to be sensitive enough to detect early disease changes in ALS because there is considerable overlap between the metabolic peak area ratios from patients with ALS and normal control subjects. However, changes in the NAA/(Cr+PCr) metabolic peak area ratios correlate with clinical measures of disease severity, and this measure may be useful in monitoring disease progression.
Supported by the Medical Research Council and the Motor Neuron Disease Association, UK.
Received February 9, 1998. Accepted in final form June 13, 1998.
This article has been cited by other articles:
|
|
 |
|
  M. Nelles, W. Block, F. Traber, U. Wullner, H.H. Schild, and H. Urbach Combined 3T Diffusion Tensor Tractography and 1H-MR Spectroscopy in Motor Neuron Disease AJNR Am. J. Neuroradiol., October 1, 2008; 29(9): 1708 - 1714. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P Valsasina, F Agosta, B Benedetti, D Caputo, M Perini, F Salvi, A Prelle, and M Filippi Diffusion anisotropy of the cervical cord is strictly associated with disability in amyotrophic lateral sclerosis J. Neurol. Neurosurg. Psychiatry, May 1, 2007; 78(5): 480 - 484. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Mitsumoto, A. M. Ulug, S. L. Pullman, C. L. Gooch, S. Chan, M. -X. Tang, X. Mao, A. P. Hays, A. G. Floyd, V. Battista, et al. Quantitative objective markers for upper and lower motor neuron dysfunction in ALS Neurology, April 24, 2007; 68(17): 1402 - 1410. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.A. Butman and M.K. Floeter Decreased Thickness of Primary Motor Cortex in Primary Lateral Sclerosis AJNR Am. J. Neuroradiol., January 1, 2007; 28(1): 87 - 91. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Kalra, C. C. Hanstock, W. R. W. Martin, P. S. Allen, and W. S. Johnston Detection of Cerebral Degeneration in Amyotrophic Lateral Sclerosis Using High-Field Magnetic Resonance Spectroscopy. Arch Neurol, August 1, 2006; 63(8): 1144 - 1148. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Cosottini, M. Giannelli, G. Siciliano, G. Lazzarotti, M. C. Michelassi, A. Del Corona, C. Bartolozzi, and L. Murri Diffusion-Tensor MR Imaging of Corticospinal Tract in Amyotrophic Lateral Sclerosis and Progressive Muscular Atrophy Radiology, October 1, 2005; 237(1): 258 - 264. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Sach, G. Winkler, V. Glauche, J. Liepert, B. Heimbach, M. A. Koch, C. Buchel, and C. Weiller Diffusion tensor MRI of early upper motor neuron involvement in amyotrophic lateral sclerosis Brain, February 1, 2004; 127(2): 340 - 350. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kalra, N. R. Cashman, Z. Caramanos, A. Genge, and D. L. Arnold Gabapentin Therapy for Amyotrophic Lateral Sclerosis: Lack of Improvement in Neuronal Integrity Shown by MR Spectroscopy AJNR Am. J. Neuroradiol., March 1, 2003; 24(3): 476 - 480. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Suhy, R.G. Miller, R. Rule, N. Schuff, J. Licht, V. Dronsky, D. Gelinas, A.A. Maudsley, and M.W. Weiner Early detection and longitudinal changes in amyotrophic lateral sclerosis by 1H MRSI Neurology, March 12, 2002; 58(5): 773 - 779. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Ellis, J. Suckling, E. Amaro Jr., E. T. Bullmore, A. Simmons, S. C.R. Williams, and P. N. Leigh Volumetric analysis reveals corticospinal tract degeneration and extramotor involvement in ALS Neurology, November 13, 2001; 57(9): 1571 - 1578. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. C. Bowen and W. G. Bradley Amyotrophic Lateral Sclerosis: The Search for a Spectroscopic Marker of Upper Motoneuron Involvement Arch Neurol, May 1, 2001; 58(5): 714 - 716. [Full Text] [PDF]
|
|
|
|
|
|
C. Pohl, W. Block, J. Karitzky, F. Traber, S. Schmidt, C. Grothe, R. Lamerichs, H. Schild, and T. Klockgether Proton Magnetic Resonance Spectroscopy of the Motor Cortex in 70 Patients With Amyotrophic Lateral Sclerosis Arch Neurol, May 1, 2001; 58(5): 729 - 735. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Khader and F. G. Greiner Neuroradiology Case of the Day RadioGraphics, November 1, 1999; 19(6): 1696 - 1698. [Full Text] [PDF]
|
|
|
|
|
|
C. M. Ellis, A. Simmons, D. K. Jones, J. Bland, J. M. Dawson, M. A. Horsfield, S. C. R. Williams, and P. N. Leigh Diffusion tensor MRI assesses corticospinal tract damage in ALS Neurology, September 1, 1999; 53(5): 1051 - 1051. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Filippi, C. Tortorella, and M. Bozzali Normal-appearing white matter changes in multiple sclerosis: the contribution of magnetic resonance techniques Multiple Sclerosis, August 1, 1999; 5(4): 273 - 282. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
