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Imaging Technique May Aid In Amyotrophic Lateral Sclerosis

Metabolite changes measured by (1)H MRSI may provide a surrogate marker of amyotrophic lateral sclerosis that can aid detection of early disease, and monitor progression and treatment response.

Sixteen patients with definite or probable amyotrophic lateral sclerosis (ALS), 12 with possible or suspected ALS and 12 healthy controls participated in this three-pronged study by J Suhy and colleagues from University of California at San Francisco, San Francisco, California, United States.

The authors sought to determine:

1) the reproducibility of metabolite measurements by (1)H MRS in the motor cortex;

2) the extent to which (1)H MRS imaging (MRSI) detects abnormal concentrations of N-acetylaspartate (NAA)-, choline (Cho)-, and creatine (Cre)-containing compounds in early stages of ALS; and,

3) the metabolite changes over time in ALS.

All of the participants underwent structural MRI and multislice (1)H MRSI. The (1)H MRSI data were coregistered with tissue-segmented MRI data to obtain concentrations of NAA, Cre, and Cho in the left and right motor cortex and in grey matter and white matter of nonmotor regions in the brain.

In the motor cortex tissue, the interclass correlation coefficient of NAA was 0.53; in nonmotor cortex tissue, it was 0.83.

When researchers compared cross-sectional data for patients with those for controls, the NAA/(Cre + Cho) ratio in the motor cortex region was significantly reduced. This was largely due to increases in Cre and Cho and a decrease in NAA concentrations.

Although it was not significant, a similar trend of increased Cho and Cre and reduced NAA levels was also observed for patients with possible or suspected ALS. Furthermore, in longitudinal studies, decreases in NAA, Cre, and Cho concentrations were detected in motor cortex but not in nonmotor regions in ALS.

Thus, (1)H MRSI may be useful in helping to detect early ALS and to monitor its progression and treatment, these authors conclude.
Neurology 2002 Mar 12;58(5):773-9. "Early detection and longitudinal changes in amyotrophic lateral sclerosis by 1 H MRSI"

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