title: Flow-metabolism uncoupling in the cervical spinal cord of ALS patients.
abstract: Amyotrophic lateral sclerosis (ALS) is a fatal motor neuron disease. In ALS, both glucose consumption and neuronal intensity reportedly decrease in the cerebral motor cortex when measured by positron emission tomography (PET). In this study, we evaluated cervical spinal glucose metabolism, blood flow, and neuronal intensity of 10 ALS patients with upper extremity (U/E) atrophy both with18F-2-fluoro-2-deoxy-D-glucose (18F-FDG) PET and11C-flumazenil (11C-FMZ) PET. On the ipsilateral side of C5 and T1 levels,18F-FDG uptake increased significantly (*p < 0.05), and was correlated with the rate of progression of the ALS FRS-R-U/E score (R = 0.645, *p = 0.041). Despite this hyperglucose metabolism, the11C-FMZ PET study did not show a coupled increase of spinal blood flow even though neuronal intensity did not decrease. These results indicate a strong correlation between hyperglucose metabolism and ALS progression alongside the uncoupling of flow-metabolism. This mechanism, which could result in subsequent motor neuronal death, may be a potential therapeutic target for ALS.
authors.affiliation: Department of Neurology, Graduate School of Medicine, Dentistry and Pharmacy, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Yamashita
authors.affiliation: Department of Neurological Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Hatakeyama
authors.affiliation: Department of Neurology, Graduate School of Medicine, Dentistry and Pharmacy, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Sato
authors.affiliation: Department of Neurology, Graduate School of Medicine, Dentistry and Pharmacy, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Fukui
authors.affiliation: Department of Neurology, Graduate School of Medicine, Dentistry and Pharmacy, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
authors.forename: Nozomi
authors.initials: N
authors.lastname: Hishikawa
authors.affiliation: Department of Neurology, Graduate School of Medicine, Dentistry and Pharmacy, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Ohta
authors.affiliation: Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nishiyama
authors.affiliation: Department of Neurological Surgery, Kagawa General Rehabilitation Hospital, Kagawa, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kawai
authors.affiliation: Department of Neurological Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Tamiya
authors.affiliation: Department of Neurology, Graduate School of Medicine, Dentistry and Pharmacy, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan. tooy@d1.dion.ne.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Abe
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000000981:diagnostic imaging* / Q000378:metabolism*; D001284:Atrophy; D002250:Carbon Radioisotopes; D066193:Cervical Cord / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000378:metabolism*; D005260:Female; D005442:Flumazenil; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D012039:Regional Blood Flow; D012815:Signal Processing, Computer-Assisted; D013904:Thoracic Vertebrae; D014057:Tomography, X-Ray Computed; D034941:Upper Extremity / Q000503:physiopathology
chemical_list: D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005442:Flumazenil; D005947:Glucose
keywords: 11C-FMZ; 18F-FDG; ALS; Flow-metabolism uncoupling; Glucose metabolism; PET