Spectroscopic markers of neurodegeneration in the mesial prefrontal cortex predict survival in ALS

Chris Hanstock, Kerry Sun, Changho Choi, Dean Eurich, Richard Camicioli, Wendy Johnston, Sanjay Kalra

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background and objective: N-acetylaspartate (NAA) and myo-inositol (mIns) are spectroscopic markers of neuronal integrity and astrogliosis, respectively. We performed a survival analysis to determine the prognostic value of the NAA/mIns metabolite ratio in ALS after a period of two and five years. Methods: Twenty-four patients with ALS (two with ALS-FTD) were recruited to participate in a high-field MR spectroscopy study of the mesial prefrontal cortex. Univariate and multivariate Cox proportional hazards analyses were used to assess NAA/mIns as a predictor of survival alongside other demographic and clinical measures. Census dates were set at two and five years after the time of MR scan for each patient. Survival curves were calculated using the Kaplan–Meier method. Results: After a five-year observation period, 19 patients had died and five were still alive. Median survival time from date of scan was 1.95 years. Univariate and multivariate Cox analysis showed NAA/mIns to be a significant independent predictor of survival at two years after scanning, but not at five years. Conclusion: Cerebral degeneration in the mesial prefrontal cortex as detected by the NAA/mIns metabolite ratio is predictive of survival in ALS in a time-dependent manner.

Original languageEnglish (US)
Pages (from-to)246-251
Number of pages6
JournalAmyotrophic Lateral Sclerosis and Frontotemporal Degeneration
Issue number3-4
StatePublished - Apr 2 2020


  • ALS
  • MR spectroscopy
  • survival

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


Dive into the research topics of 'Spectroscopic markers of neurodegeneration in the mesial prefrontal cortex predict survival in ALS'. Together they form a unique fingerprint.

Cite this