title: Degeneration of the mid-cingulate cortex in amyotrophic lateral sclerosis detected in vivo with MR spectroscopy.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Sudharshan
authors.forename: C
authors.initials: C
authors.lastname: Hanstock
authors.forename: B
authors.initials: B
authors.lastname: Hui
authors.forename: T
authors.initials: T
authors.lastname: Pyra
authors.forename: W
authors.initials: W
authors.lastname: Johnston
authors.forename: S
authors.initials: S
authors.lastname: Kalra
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000378:metabolism* / Q000473:pathology*; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D002794:Choline / Q000378:metabolism; D005260:Female; D006179:Gyrus Cinguli / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000378:metabolism / Q000473:pathology; D009410:Nerve Degeneration / Q000378:metabolism / Q000473:pathology; D009434:Neural Pathways / Q000378:metabolism / Q000473:pathology; D013788:Thalamus / Q000378:metabolism / Q000473:pathology
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D002794:Choline