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We performed proton magnetic resonance spectroscopic imaging(H-MRSI)in patients with motor neuron disease(MND)to evaluate the distribution and extent of cortical neuron damage or loss as reflected by decreased N- acetyl(NA)to creatine(Cr)resonance intensity ratios.Compared with healthy controls,ALS patients had a significant decrease in NA/Cr resonance intensity ratios,most prominently in the primary cortex(p<0.001)but also to varying degrees,in primary sensory(p<0.01)posterior premotor and parietal regions.Patients classified as ALS-PUMNS showed less prominent reduction in NA-CR ratios in the same regions;patients with PSMA had normal cortical NA\Cr ratios. |
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