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

  • Diagnostic Neuroradiology
  • Published:
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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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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Clinic of Neurology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic

    Štefan Sivák, Egon Kurča, Monika Turčanová-Koprušáková, Milan Grofik & Vladimír Nosáľ

  2. Department of Medical Biochemistry, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic

    Michal Bittšanský & Dušan Dobrota

  3. Clinic of Radiodiagnostics, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic

    Hubert Poláček

  4. Jessenius Medical Faculty, Clinic of Neurology, Kollarova 2, Martin, 03601, Slovakia

    Štefan Sivák

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Correspondence to Štefan Sivák.

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Sivák, Š., Bittšanský, M., Kurča, E. et al. Proton magnetic resonance spectroscopy in patients with early stages of amyotrophic lateral sclerosis. Neuroradiology 52, 1079–1085 (2010). https://doi.org/10.1007/s00234-010-0685-6

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  • DOI: https://doi.org/10.1007/s00234-010-0685-6

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