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Neurology. 2010 Mar 9;74(10):821-7. doi: 10.1212/WNL.0b013e3181d3e2dd. Epub 2010 Feb 10.
The goal of this study is to determine if regional brain perfusion, as measured by arterial spin labeling (ASL) MRI, is correlated with clinical measures of amyotrophic lateral sclerosis (ALS) disease severity. The presence of such a relationship would indicate a possible role for ASL perfusion as a marker of disease severity and upper motor neuron involvement in ALS.
Disease severity was assessed in 16 subjects with ALS (age 54 +/- 11) using the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS) and the pulmonary function measure, forced vital capacity (FVC). Upper motor neuron involvement was assessed by testing rapid tapping of the fingers and feet. Magnetic resonance perfusion images were coregistered with structural T1-weighted MRI, corrected for partial volume effects using the structural images and normalized to a study-specific atlas. Correlations between perfusion and ALS disease severity were analyzed, using statistical parametric mapping, and including age as a factor. Analyses were adjusted for multiple clusters.
ALS severity, as measured by the ALSFRS and FVC, was correlated with gray matter perfusion. This correlation was predominantly observed in the hemisphere contralateral to the more affected limbs. ALSFRS scores correlated with perfusion in the contralateral frontal and parietal lobe (p < 0.001) and ipsilateral frontal lobe (p < 0.02). FVC scores correlated with gray matter perfusion in contralateral frontal lobe (p < 0.001). Upper motor neuron involvement, as measured by rapid finger tapping, correlated bilaterally with perfusion in the middle cingulate gyrus (p < 0.001).
Amyotrophic lateral sclerosis (ALS) severity is correlated with brain perfusion as measured by arterial spin labeling (ASL) perfusion. This correlation appears to be independent of brain atrophy. ASL perfusion may be a useful tool for monitoring disease progression and assessing treatment effects in ALS.
本研究旨在确定脑区域性灌注（通过动脉自旋标记（ASL）MRI 测量）是否与肌萎缩侧索硬化症（ALS）疾病严重程度的临床测量相关。如果存在这种关系，则表明 ASL 灌注可能作为疾病严重程度和 ALS 中运动神经元受累的标志物发挥作用。
使用肌萎缩侧索硬化功能评定量表（ALSFRS）和肺功能测量用力肺活量（FVC）评估 16 名 ALS 患者（年龄 54±11）的疾病严重程度。通过测试手指和脚部的快速敲击来评估运动神经元受累情况。将灌注磁共振图像与结构 T1 加权 MRI 配准，使用结构图像校正部分容积效应，并归一化为特定于研究的图谱。使用统计参数映射分析灌注与 ALS 疾病严重程度之间的相关性，并将年龄作为因素。对分析结果进行调整，以考虑多个聚类。
ALS 严重程度（通过 ALSFRS 和 FVC 测量）与灰质灌注相关。这种相关性主要在受影响肢体对侧的半球中观察到。ALSFRS 评分与对侧额顶叶（p<0.001）和同侧额叶（p<0.02）的灌注相关。FVC 评分与对侧额叶的灰质灌注相关（p<0.001）。快速手指敲击测量的运动神经元受累情况与双侧中扣带回的灌注相关（p<0.001）。
肌萎缩侧索硬化症（ALS）严重程度与动脉自旋标记（ASL）灌注测量的脑灌注相关。这种相关性似乎与脑萎缩无关。ASL 灌注可能是监测 ALS 疾病进展和评估治疗效果的有用工具。
