Metabolite metrics in the length of the intracranial corticospinal tracts in the ALS and control groups.

<p>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.</p

Intracranial corticospinal tract atlas.

<p>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.</p

Clinical measures of motor neuron function in the ALS group.

*<p>Rates are provided in s⁻¹;</p>**<p>mean of <i>la-la</i> and <i>pa-pa</i> syllable repeat rates.</p

Representative ¹H-MR spectra in the brain of a patient with ALS.

<p>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.</p

Within session and between session intraclass correlation coefficient for metabolites.

<p>Data displayed are mean (95% Confidence interval) intraclass correlation coefficient for metabolite ratios (Choline (Cho)/Creatine (Cr), N Acetyl Aspartate (NAA)/Cho, NAA/Cr) and metabolites (NAA, Cho and Cr) for mixed cortical and deep grey, and white matter brain regions.</p><p>Within session and between session intraclass correlation coefficient for metabolites.</p

Analysis of variance table for metabolite ratios.

<p>Data were obtained from 32 volunteers using the region of interest (ROI) template for and metabolite concentrations. (Choline – Cho, Creatine – Cr, N acetyl aspartate – NAA and DF – Degrees of freedom).</p><p>Analysis of variance table for metabolite ratios.</p

Within session and between session variability of metabolites for whole brain proton spectroscopy.

<p><i>Individual region of interest measurements for within session reproducibility obtained in the first and second imaging sessions in 17 and 16 subjects respectively, and the between session reproducibility for those 22 subjects who underwent imaging at both sessions. Data displayed are standard deviation for metabolite ratios (Choline (Cho)/Creatine (Cr), N-Acetyl aspartate (NAA)/Choline and NAA/Cr.</i></p><p>Within session and between session variability of metabolites for whole brain proton spectroscopy.</p

Metabolite parametric maps.

<p>T1 weighted magnetic resonance image in MNI152 space (2mm resolution) with a representative spectra from the right thalamus and N-acetyl aspartate (NAA), Creatine (Cr) and Choline (Cho) signal-intensity normalised metabolite concentration parametric maps. PPM (parts per million).</p

Variability in N Acetyl Aspartate/Creatine ratio measurements.

<p>Box and whisker plot for N Acetyl Aspartate/Creatine ratio for a selection of the regions of interest (ROI), including right (R) and left (L) corticospinal (CST), anterior thalamic radiation (ATR), thalamus, putamen, frontal lobe, hippocampus and temporal lobe. The spread of data within each ROI reflects inter subject variation, while the difference between runs 1 – 2 and 3 – 4 reflects within session reproducibility, and the change from first to second sessions reflects between session reproducibility. The central lines in each box denote median values, the lower and upper boundaries the 25th and 75th centile, the error bars the 10th and 90th centile, and the closed circles outlying data points.</p

Analysis of variance table for metabolite ratios.

<p>Data were obtained from 32 volunteers using the region of interest (ROI) template for metabolite ratios. (Choline – Cho, Creatine – Cr, N acetyl aspartate – NAA and DF – Degrees of freedom).</p><p>Analysis of variance table for metabolite ratios.</p