Table 1.
Disease duration and severity of the patients in the ALS group.
Table 2.
Clinical measures of motor neuron function in the ALS group.
Figure 1.
Representative 1H-MR spectra in the brain of a patient with ALS.
1H-MR spectra obtained at 3T from six anatomical regions (square boxes on the MRIs) along the length of the corticospinal tract in the brain of a patient with ALS (male, 43 years) are shown. (a: medulla; b: pons/midbrain, c: left internal capsule; d: left corona radiata; e: left centrum semiovale; f: left precentral gyrus/subcortical white matter). The spectra shown were obtained by averaging spectra from 2.7 mL to 6.0 mL contiguous voxels in that region.
Figure 2.
Intracranial corticospinal tract atlas.
The full-range probabilistic atlas is shown in green. We modified this atlas (shown in red) for our use by including only voxels with probability values greater than 0.20 and by excluding voxels inferior to the cerebral peduncle. The axial MRI image is included to provide anatomical context.
Figure 3.
Comparison of intracranial corticospinal tract (CST) metabolite values between the ALS and control groups.
Comparisons of the left (A) and right (B) entire intracranial corticospinal tract (CST) metabolite values (mean ± SD) in the ALS (n = 38) and control (n = 70) groups (age range: 34–65 years) using ANCOVA. The green and orange histograms indicate the metabolite values of the entire intracranial CST in the ALS and control groups, respectively. The asterisks indicate significant group differences with *p<0.05, **p<0.005 and ***p<0.0001. The significant percent differences found were: −8.9 (left) and −6.2 (right) in NAA, +8.1 (left) and +7.5 (right) in Cho, and +20.0 (left) and +15.7 (right) in Cho/NAA. The abbreviations used indicate as NAA: N-acetyl aspartate; Cre: total-creatine; Cho: total-choline; I. U.: institutional units.
Figure 4.
Segmented intracranial corticospinal tract (CST) atlas and the somatotopic arrangement within the primary motor cortex.
The probabilistic corticospinal tract (CST) atlas is overlaid onto the coronal orientation T1-MRI template (Montreal Neurological Institute). The color bar indicates the full range of the probability values in the CST atlas. The horizontal lines indicate the approximate anatomical levels at which the five segments were made along the length of the CST. PCG: Precentral gyrus, CS: Centrum semiovale, CR: Corona radiata, PLIC: Posterior limb of the internal capsule, CP: Cerebral peduncle and R: Right side of the subject. The blue, green and purple lines indicate the somatotopic arrangement within the primary motor cortex that are associated with the face and lower and upper limb parts, respectively.
Figure 5.
Metabolite metrics in the length of the intracranial corticospinal tracts in the ALS and control groups.
Metabolite metrics along the length of the intracranial corticospinal tracts (CST) in patients with ALS (blue; n = 38) and control (red; n = 70) groups in the age range of 34–65 years using ANCOVA. The asterisks indicate significant group differences with *p<0.05, **p<0.005 and ***p<0.0001. The abbreviations used indicate as NAA: N-acetyl aspartate, Cho: total-choline, Cre: total-creatine, PCG: precentral gyrus, CS: centrum semiovale, CR: corona radiata, PLIC: posterior limb of internal capsule, CP: cerebral peduncle, and I.U.: institutional units.
Table 3.
P-values of the metabolite comparisons between the intracranial CST segments in each hemisphere in the control group.
Table 4.
P-values of the metabolite comparisons between the intracranial CST segments in each hemisphere in the ALS group.