1H-MRSI of the Deep Gray Matter Nuclei in Patients With Amyotrophic Lateral Sclerosis

Motivation: There is a need to define early biomarkers of amyotrophic lateral sclerosis (ALS) by investigating metabolic differences in patients with distinct regional onsets. Goal(s): Identify specific metabolic differences among ALS patients based on their regional and limb onsets. Approach: 1H-MRSI data from deep gray matter nuclei of 29 ALS patients were quantified using LCModel and compared between different onset groups. Results: Lumbosacral onset patients showed higher tNAA/tCr and Tau/tCr in white matter than cervical onset patients. ALS patients had elevated Glu/tCr in the left putamen for the left onset and in the right caudate for the right onset. Impact: This study demonstrated that alterations in tNAA/tCr, Tau/tCr, and Glu/tCr ratios could enhance the understanding of ALS pathophysiology in distinct regional and limb onset groups and potentially contribute to future treatment planning.