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Abstract
Objective: To demonstrate the sensitivity of a recently developed whole-brain magnetic resonance spectroscopic imaging (MRSI) sequence to cerebral pathology and disability in amyotrophic lateral sclerosis (ALS), and compare with measures derived from diffusion tensor imaging.
Methods: Whole-brain MRSI and diffusion tensor imaging were undertaken in 13 patients and 14 age-similar healthy controls. Mean N-acetylaspartate (NAA), fractional anisotropy, and mean diffusivity were extracted from the corticospinal tract, compared between groups, and then in relation to disability in the patient group.
Results: Significant reductions in NAA were found along the course of the corticospinal tracts on whole-brain MRSI. There were also significant changes in fractional anisotropy (decreased) and mean diffusivity (increased) in the patient group, but only NAA showed a significant relationship with disability (r = 0.65, p = 0.01).
Conclusion: Whole-brain MRSI has potential as a quantifiable neuroimaging marker of disability in ALS. It offers renewed hope for a neuroimaging outcome measure with the potential for harmonization across multiple sites in the context of a therapeutic trial.
Glossary
- ALS=
- amyotrophic lateral sclerosis;
- ALSFRS-R=
- Amyotrophic Lateral Sclerosis Functional Rating Scale–revised;
- CST=
- corticospinal tract;
- DTI=
- diffusion tensor imaging;
- FA=
- fractional anisotropy;
- LMN=
- lower motor neuron;
- MD=
- mean diffusivity;
- MIDAS=
- Metabolite Imaging and Data Analysis System;
- MRSI=
- magnetic resonance spectroscopic imaging;
- NAA=
- N-acetylaspartate;
- OR=
- optic radiation;
- PLS=
- primary lateral sclerosis;
- TBSS=
- tract-based spatial statistics;
- WM=
- white matter
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at www.neurology.org
Editorial, page 606
- Received July 18, 2012.
- Accepted September 26, 2012.
- © 2013 American Academy of Neurology
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