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Neuroradiology
Published in: Neuroradiology 12/2010

01-12-2010 | Diagnostic Neuroradiology

Proton magnetic resonance spectroscopy in patients with early stages of amyotrophic lateral sclerosis

Authors: Štefan Sivák, Michal Bittšanský, Egon Kurča, Monika Turčanová-Koprušáková, Milan Grofik, Vladimír Nosáľ, Hubert Poláček, Dušan Dobrota

Published in: Neuroradiology | Issue 12/2010

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Abstract

Introduction

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder primarily affecting upper and lower motor neurons. Due to relative fast progression of the disease, early diagnosis is essential. Proton magnetic resonance spectroscopy (1H-MRS) is used for objectivization of upper motor neuron (UMN) lesions. The aim of this study was to assess the use of 1H-MRS in the early stages of ALS.

Methods

Eleven patients with clinically definite (n = 2), probable (n = 7), and probable laboratory-supported (n = 2) diagnosis of ALS with disease duration of less than 14 months were studied. Control group consists of 11 sex- and age-matched healthy subjects. All subjects underwent assessment of functional disability using revised ALS Functional Rating Scale (ALSFRS-R) and single-voxel 1H-MRS examination of both precentral gyri, pons, medulla oblongata, and occipital lobe. Spectra were evaluated with LCModel software.

Results

The mean disease duration was 6.5 ± 3.5 months. The median ALSFRS-R was 42. Significant decrease between patient and control groups was found in the NAA/Cre ratio in the left and right precentral gyri (p = 0.008, p = 0.040). Other metabolite ratios in other areas did not show significant differences. Total ALSFRS-R score weakly positively correlated with NAA/Cre ratio in the left precentral gyrus (p = 0.047).

Conclusions

1H-MRS is sensitive to detect metabolic changes caused by neurodegeneration processes during ALS and can be used for detection of UMN dysfunction. These MRS changes in the early stages of ALS are most prominent in motor cortex.
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Metadata
Title
Proton magnetic resonance spectroscopy in patients with early stages of amyotrophic lateral sclerosis
Authors
Štefan Sivák
Michal Bittšanský
Egon Kurča
Monika Turčanová-Koprušáková
Milan Grofik
Vladimír Nosáľ
Hubert Poláček
Dušan Dobrota
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
Neuroradiology / Issue 12/2010
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-010-0685-6

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