title: Proton magnetic resonance spectroscopic imaging in childhood ataxia with diffuse central nervous system hypomyelination.
abstract: The spatial distribution of metabolite signal intensities can be measured within entire sections of the brain by proton magnetic resonance spectroscopic imaging (1H-MRSI). A group of six patients (4 unrelated girls and 2 brothers from 5 families) with childhood ataxia with diffuse CNS hypomyelination (CACH) underwent long-echo-time, single-slice 1H-MRSI. Relative to controls, there was a decrease in the signal intensity of N-acetylaspartate, choline, and creatine throughout the white matter in all six patients. We identified lactate signals in white matter in three of them with advanced disease. The degree of white matter involvement was not homogeneous over the entire patient group, but did correlate with clinical presentation. Deep and posterior white matter tended to be more involved. There were no 1H-MRSI abnormalities in the gray matter. 1H-MRSI findings suggest that this syndrome is secondary to a metabolic defect causing hypomyelination, axonal degeneration, and, in the most compromised cases, accumulation of lactate. This study shows that CACH is not limited to girls.
authors.affiliation: Neuroimaging Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: G
authors.initials: G
authors.lastname: Tedeschi
authors.forename: R
authors.initials: R
authors.lastname: Schiffmann
authors.forename: N W
authors.initials: NW
authors.lastname: Barton
authors.forename: H H
authors.initials: HH
authors.lastname: Shih
authors.forename: S M
authors.initials: SM
authors.lastname: Gospe
authors.forename: R O
authors.initials: RO
authors.lastname: Brady
authors.forename: J R
authors.initials: JR
authors.lastname: Alger
authors.forename: G
authors.initials: G
authors.lastname: Di Chiro
mesh_terms: D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001259:Ataxia / Q000175:diagnosis*; D001921:Brain / Q000378:metabolism; D001927:Brain Diseases / Q000175:diagnosis* / Q000473:pathology*; D002675:Child, Preschool; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D005260:Female; D005776:Gaucher Disease / Q000175:diagnosis; D006801:Humans; D007773:Lactates / Q000378:metabolism; D019344:Lactic Acid; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009186:Myelin Sheath / Q000473:pathology*; D011522:Protons
chemical_list: D007773:Lactates; D011522:Protons; D001224:Aspartic Acid; D019344:Lactic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline