Department of Neurology, University of Miami, Miller School of Medicine, 1150 NW 14th St., Miami, FL 33136, USA.
NMR Biomed. 2011 Dec;24(10):1270-6. doi: 10.1002/nbm.1687. Epub 2011 Mar 15.
Previous studies have evaluated motor and extramotor cerebral cortical regions in patients with amyotrophic lateral sclerosis (ALS) using (1) H MRS, but none have evaluated the thalamus or basal ganglia. The objective of this exploratory study was to evaluate the subclinical involvement of the basal ganglia and thalamus in patients with ALS using (1) H MRS. Fourteen patients (52±7 years) with sporadic definite ALS and 17 age-matched controls were studied using volumetric MRSI on a 3-T scanner. The concentration of the metabolites N-acetylaspartate (NAA), choline (Cho) and their ratio (NAA/Cho) were obtained bilaterally from the basal ganglia (lentiform nucleus, caudate) and thalamus. The maximum rates of finger and foot tap and lip and tongue movements were obtained to assess extrapyramidal and pyramidal tract function. In patients with ALS, relative to controls, the NAA concentration was significantly lower (p<0.02) in the basal ganglia and thalamus, and the Cho concentration was higher (p<0.01) in these structures, except in the caudate (p=0.04). Correspondingly, the NAA/Cho ratio was significantly lower (p<0.01) in these structures, except in the caudate (p=0.03), in patients than in controls. There were mild to strong correlations (r=0.4-0.7) between the metabolites of the basal ganglia and finger tap, foot tap and lip and tongue movement rates. In conclusion, decreased NAA in the basal ganglia and thalamus and increased Cho and decreased NAA/Cho in the lentiform nucleus and thalamus are indicative of neuronal loss or dysfunction and alterations in choline-containing membranes in these structures.
先前的研究已经使用 (1) H MRS 评估了肌萎缩侧索硬化症 (ALS) 患者的运动和运动外皮质脑区，但没有研究评估丘脑或基底节。本探索性研究的目的是使用 (1) H MRS 评估 ALS 患者基底节和丘脑的亚临床受累情况。使用 3T 扫描仪上的容积 MRSI 对 14 名（52±7 岁）散发明确的 ALS 患者和 17 名年龄匹配的对照者进行了研究。从基底节（豆状核、尾状核）和丘脑双侧获得代谢物 N-乙酰天门冬氨酸 (NAA)、胆碱 (Cho) 及其比值 (NAA/Cho) 的浓度。获得手指和脚敲击以及嘴唇和舌头运动的最大速度，以评估锥体外系和锥体束功能。与对照组相比，ALS 患者的基底节和丘脑的 NAA 浓度显著降低（p<0.02），而这些结构中的 Cho 浓度显著升高（p<0.01），除了尾状核（p=0.04）。相应地，除了尾状核（p=0.03），这些结构中的 NAA/Cho 比值显著降低（p<0.01），在患者中比在对照组中。基底节代谢物与手指敲击、脚敲击以及嘴唇和舌头运动速度之间存在轻度到强烈的相关性（r=0.4-0.7）。总之，基底节和丘脑的 NAA 减少，豆状核和丘脑的 Cho 增加，NAA/Cho 减少，表明这些结构中的神经元丢失或功能障碍以及含胆碱膜的改变。
