Nazem Atassi1, Christina Triantanfyllou2, Boris Keil2, Robert Lawson1, Lindsay Kaplan1, Christina Dheel1, Alyssa Murphy1, James Berry1, Nouha Salibi3, Ravi T. Seethamraju4, Bruce Rosen2, Merit Cudkowicz1, Eva-Maria Ratai2
1Neurology, Massachusetts General Hospital, Boston, MA, United States; 2Radiology, MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, United States; 3Siemens Healthcare, MR R&D, Siemens, Auburn, AL, United States; 4Siemens Healthcare, MR R&D, Siemens, Charlestown, MA, United States
High field (7T) MR spectroscopy, specifically ultra short TE STEAM with VAPOR water suppression was used to study brain metabolite concentrations in people with Amyotrophic Lateral Sclerosis (ALS). N-acetylaspartate/creatine was decreased in ALS in the motor cortex indicating neuronal injury or loss. Contrary to our initial hypothesis, glutamate was decreased in the ALS group without significant changes in glutamine. Interestingly, myo-Inositol/creatine was increased in the ALS group suggesting increased glial proliferation and inflammation in the motor cortex. Furthermore, the increase in myo-Inositol/creatine strongly correlated with pathological reflexes, a clinical marker of upper motor neuron degeneration.