Detection of cerebral degeneration in amyotrophic lateral sclerosis using high-field magnetic resonance spectroscopy
Detection of cerebral degeneration in amyotrophic lateral sclerosis using high-field magnetic resonance spectroscopy
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DOI：
10.1001/archneur.63.8.1144
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发表时间：
2006-08-01
影响因子：
--
通讯作者：
Johnston, Wendy S.
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文献类型：
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作者：
Kalra, Sanjay;Hanstock, Christopher C.;Johnston, Wendy S.
背景：临床评估对肌萎缩侧索硬化（ALS）的脑受累程度不敏感。局部脑浓度N-乙酰基谷氨酸盐（NAA）加上肌醇（Ins），如通过磁共振波谱测量的，分别减少和增加，表明这些化合物可以提供ALS患者脑受累程度的生物标志物。目的：检验NAA/Ins比值可以提供ALS患者脑受累指数的假设。设计：高场采用3.0 T磁共振波谱仪测定17例ALS患者和15例健康对照者运动皮层中NAA/肌酸加磷酸肌酸（NAA/Cr）、NAA/胆碱（NAA/Cho）、Ins/Cr和NAA/Ins比值。在ALS患者中，最大的异常是NAA/Ins降低22（敏感性71%，特异性93%，P= 0.001）; Ins/Cr增加18%（敏感性88%，特异性53%，P= 0.04），NAA/Cr降低10%（敏感性88%，特异性47%，P= 0.04），NAA/Cho降低14%（敏感性53%，特异性87%，P= 0.047）。ALS功能评定量表与NAA/Ins的相关性接近统计学意义（R=0.43，P= 0.07）。结论：NAA/Ins比值具有最佳的敏感性和特异性，可作为ALS的生物标志物。
Background: Clinical assessment is insensitive to the degree of cerebral involvement in amyotrophic lateral sclerosis (ALS). Regional brain concentrations N-acetylaspartylglutamate (NAA) plus myo-inositol (Ins), as measured by magnetic resonance spectroscopy, are respectively decreased and increased, suggesting that these compounds may provide a biomarker of the degree of cerebral involvement in ALS.Objective: To test the hypothesis that the NAA/Ins ratio may provide an index of cerebral involvement in patients with ALS.Design: High-field (3.0-T) magnetic resonance spectroscopy was performed to determine the NAA/creatine plus phosphocreatine (NAA/Cr), NAA/choline (NAA/Cho), Ins/Cr, and NAA/Ins ratios in the motor cortex.Participants: Seventeen patients with ALS and 15 healthy control subjects were studied.Results: In patients with ALS, the greatest abnormality was a 22% decrease in NAA/Ins (71% sensitivity and 93% specificity, P=.001); Ins/Cr was increased 18% (88% sensitivity and 53% specificity, P=.04), NAA/Cr was decreased 10% (88% sensitivity and 47% specificity, P=.04), and NAA/Cho was decreased 14% (53% sensitivity and 87% specificity, P=.047). Correlation of the ALS Functional Rating Scale with NAA/Ins approached statistical significance (R=0.43, P=.07).Conclusion: The NAA/Ins ratio may provide a meaningful biomarker in ALS given its optimal sensitivity and specificity profile.