Neuroradiology

, Volume 52, Issue 12, pp 1079–1085

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

Authors

    • Clinic of Neurology, Jessenius Faculty of MedicineComenius University
    • Jessenius Medical Faculty, Clinic of Neurology
  • Michal Bittšanský
    • Department of Medical Biochemistry, Jessenius Faculty of MedicineComenius University
  • Egon Kurča
    • Clinic of Neurology, Jessenius Faculty of MedicineComenius University
  • Monika Turčanová-Koprušáková
    • Clinic of Neurology, Jessenius Faculty of MedicineComenius University
  • Milan Grofik
    • Clinic of Neurology, Jessenius Faculty of MedicineComenius University
  • Vladimír Nosáľ
    • Clinic of Neurology, Jessenius Faculty of MedicineComenius University
  • Hubert Poláček
    • Clinic of Radiodiagnostics, Jessenius Faculty of MedicineComenius University
  • Dušan Dobrota
    • Department of Medical Biochemistry, Jessenius Faculty of MedicineComenius University
Diagnostic Neuroradiology

DOI: 10.1007/s00234-010-0685-6

Cite this article as:
Sivák, Š., Bittšanský, M., Kurča, E. et al. Neuroradiology (2010) 52: 1079. doi:10.1007/s00234-010-0685-6

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.

Keywords

Amyotrophic lateral sclerosis Magnetic resonance spectroscopy Clinical findings ALSFRS-R

Copyright information

© Springer-Verlag 2010