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In amyotrophic lateral sclerosis (ALS), both upper and lower motor neurons degenerate, contributing to clinical decline and mortality. Clinical evaluation of upper motor neuron (UMN) integrity in ALS can be limited by the presence of lower motor neuron (LMN) disease. Metabolite ratios, measured by magnetic resonance spectroscopy (MRS), have been shown to indicate UMN damage in ALS. To determine whether UMN degeneration correlates with mortality in ALS, researchers evaluated metabolite ratios in primary motor cortex.
The researchers acquired one MRS scan from each of 18 healthy control subjects and 63 subjects with ALS and clinical signs of UMN disease who were followed clinically to the time of death, tracheostomy, or the end of the 8-year s…