Abe K, Takanashi M, Watanabe Y, Tanaka H, Fujita N, Hirabuki N, Yanagihara T
Department of Neurology, Osaka University Graduate School of Medicine, Suita, Japan.
Neuroradiology. 2001 Jul;43(7):537-41. doi: 10.1007/s002340000521.
We studied whether N-acetylaspartate (NAA), a neuronal marker, is reduced in the brain of 14 patients with clinically definite amyotrophic lateral sclerosis (ALS) and whether NAA levels in the motor area and frontal lobe correlate with the clinical features, including frontal lobe function. We also studied 14 normal controls were evaluated. We obtained peak integrals in 1H magnetic resonance spectroscopy (MRS) for NAA, creatine (Cr), and choline-containing compounds (Cho). Severity of the disease was determined using the manual muscle strength test, and the Norris limb and bulbar scales. In the patients, the NAA/Cr ratio was reduced in the motor area and frontal lobe, while the Cho/Cr ratio was normal throughout the brain. There were significant correlations between the NAA/Cr ratio in the motor area and the Norris limb scale (r = 0.50; P < 0.01) and between the NAA/Cr ratio in the frontal lobe and the number of categories achieved in the Wisconsin Card Sorting test (r = 0.71; P < 0.05), implying frontal lobe dysfunction. These correlations suggest that a reduced NAA/Cr ratio is a marker of cortical neuronal loss and dysfunction in ALS.
我们研究了神经元标志物N-乙酰天门冬氨酸（NAA）在14例临床确诊的肌萎缩侧索硬化症（ALS）患者大脑中是否减少，以及运动区和额叶的NAA水平是否与包括额叶功能在内的临床特征相关。我们还对14名正常对照者进行了评估。我们通过氢质子磁共振波谱（MRS）获得了NAA、肌酸（Cr）和含胆碱化合物（Cho）的峰积分。使用徒手肌力测试以及诺里斯肢体和延髓量表来确定疾病的严重程度。在患者中，运动区和额叶的NAA/Cr比值降低，而整个大脑的Cho/Cr比值正常。运动区的NAA/Cr比值与诺里斯肢体量表之间存在显著相关性（r = 0.50；P < 0.01），额叶的NAA/Cr比值与威斯康星卡片分类测试中达到的类别数之间存在显著相关性（r = 0.71；P < 0.05），这意味着额叶功能障碍。这些相关性表明，NAA/Cr比值降低是ALS中皮质神经元丢失和功能障碍的一个标志物。
