comprehensive evaluation of corticospinal tract metabolites in amyotrophic lateral sclerosis using whole-brain 1h mr spectroscopy综合评价皮质脊髓束代谢物的肌萎缩性脊髓侧索硬化症使用全脑1 h先生光谱学.pdf

Comprehensive Evaluation of Corticospinal Tract Metabolites in Amyotrophic Lateral Sclerosis Using Whole-Brain 1H MR Spectroscopy 1 2 1 3 1 Varan Govind *, Khema R. Sharma , Andrew A. Maudsley , Kristopher L. Arheart , Gaurav Saigal , Sulaiman Sheriff1 1 Department of Radiology, University of Miami School of Medicine, Miami, Florida, United States of America, 2 Department of Neurology, University of Miami School of Medicine, Miami, Florida, United States of America, 3 Department of Epidemiology, University of Miami School of Medicine, Miami, Florida, United States of America Abstract Changes in the distribution of the proton magnetic resonance spectroscopy (MRS) observed metabolites N-acetyl aspartate (NAA), total-choline (Cho), and total-creatine (Cre) in the entire intracranial corticospinal tract (CST) including the primary motor cortex were evaluated in patients with amyotrophic lateral sclerosis (ALS). The study included 38 sporadic definite- ALS subjects and 70 age-matched control subjects. All received whole-brain MR imaging and spectroscopic imaging scans at 3T and clinical neurological assessments including percentage maximum forced vital capacity (FVC) and upper motor neuron (UMN) function. Differences in each individual metabolite and its ratio distributions were evaluated in the entire intracranial CST and in five segments along the length of the CST (at the levels of precentral gyrus (PCG), centrum semiovale (CS), corona radiata (CR), posterior limb of internal capsule (PLIC) and cerebral peduncle (CP)). Major findings included significantly decreased NAA and increased Cho and Cho/NAA in the entire intracranial CST, with the largest differences for Cho/NAA in all the groups. Significant correlations between Cho/NAA in t