Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
AJNR Am J Neuroradiol. 2011 Feb;32(2):403-7. doi: 10.3174/ajnr.A2289. Epub 2010 Nov 18.
Various lines of evidence implicate cerebral involvement beyond the motor cortex in ALS, including the cingulate gyrus and the thalamus. The purpose of this study was to assess neurodegeneration in these regions in vivo by using MRSI.
Fourteen patients with ALS and 14 healthy controls underwent MRSI by using a coronal acquisition scheme. The NAA/Cho ratio was quantified in the MCC, thalamus, and motor cortex (PCG).
NAA/Cho was reduced in the MCC in patients with ALS compared with the controls (P = .0004). There was no difference in NAA/Cho in the thalamus (P = .59). We also found a strong correlation of NAA/Cho among the PCG, MCC, and the thalamus in controls, which was absent in patients with ALS.
Neurodegeneration beyond the motor cortex is present in the MCC in ALS. The significant correlation of NAA/Cho among the PCG, MCC, and the thalamus in healthy subjects likely reflects the neuronal connectivity among these regions. The loss of these relationships in patients with ALS suggests that such connectivity is not responsible for the pattern of degeneration in these regions.
多种证据表明，ALS 除了运动皮层外，还涉及大脑其他区域的病变，包括扣带回和丘脑。本研究旨在通过 MRSI 评估这些区域的神经退行性变。
14 例 ALS 患者和 14 例健康对照者接受了冠状采集方案的 MRSI。定量测量 MCC、丘脑和运动皮层（PCG）中的 NAA/Cho 比值。
与对照组相比，ALS 患者 MCC 中的 NAA/Cho 降低（P =.0004）。在丘脑，NAA/Cho 没有差异（P =.59）。我们还发现，在对照组中，PCG、MCC 和丘脑之间的 NAA/Cho 具有很强的相关性，而在 ALS 患者中则没有这种相关性。
ALS 患者的 MCC 存在运动皮层以外的神经退行性变。在健康受试者中，PCG、MCC 和丘脑之间 NAA/Cho 的显著相关性可能反映了这些区域之间的神经元连接。在 ALS 患者中失去这些关系表明，这种连接并不是这些区域病变模式的原因。
