Gredal O, Rosenbaum S, Topp S, Karlsborg M, Strange P, Werdelin L
Research Institute of Biological Psychiatry, St. Hans Hospital, Roskilde, Denmark.
Neurology. 1997 Apr;48(4):878-81. doi: 10.1212/wnl.48.4.878.
We performed proton magnetic resonance spectroscopy (1H-MRS) in patients with motor neuron disease (MND) to determine the absolute in vivo concentrations in the brain of the metabolites N-acetyl aspartate (NAA), choline (Cho), and creatine (Cr/PCr). We examined the spectra acquired from a 20 x 20 x 20-mm3 voxel placed in the motor cortex and in the cerebellum from seven patients with clinically probable or definite amyotrophic lateral sclerosis (ALS) according to the El Escorial criteria, from three patients with suspected ALS (progressive muscular atrophy), and from eight normal control subjects. We estimated the concentrations of the metabolites using the water signal as an internal standard. The concentrations of Cho and Cr/PCr in both brain regions, as well as the concentration of NAA in the cerebellum, were unaltered in the MND patients compared with the controls. Only MND patients with both upper and lower motor neuron signs had a significantly decreased concentration of NAA (9.13 +/- 0.28 mM, mean +/- SEM) in the primary motor cortex when compared with healthy controls (10.03 +/- 0.22 mM). In conclusion, the slightly decreased concentration of NAA in the primary motor cortex from ALS patients may represent a loss of neurons in this region.
我们对运动神经元病（MND）患者进行了质子磁共振波谱分析（1H-MRS），以测定大脑中代谢物N-乙酰天门冬氨酸（NAA）、胆碱（Cho）和肌酸（Cr/PCr）的绝对体内浓度。我们检查了从根据埃尔埃斯科里亚尔标准临床诊断为可能或确诊的肌萎缩侧索硬化症（ALS）的7例患者、3例疑似ALS（进行性肌肉萎缩）患者以及8名正常对照者的运动皮层和小脑中一个20×20×20立方毫米的体素所采集的波谱。我们以水信号作为内标来估算代谢物的浓度。与对照组相比，MND患者两个脑区的Cho和Cr/PCr浓度以及小脑的NAA浓度均未改变。只有同时具有上运动神经元和下运动神经元体征的MND患者，其初级运动皮层中的NAA浓度（9.13±0.28毫摩尔，平均值±标准误）与健康对照者（10.03±0.22毫摩尔）相比显著降低。总之，ALS患者初级运动皮层中NAA浓度的轻微降低可能代表该区域神经元的丢失。
