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Query: UMLS:C0002736 (
amyotrophic lateral sclerosis
)
19,048
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Acidic excitatory amino acids have been implicated in the pathogenesis of
amyotrophic lateral sclerosis
(
ALS
). We now report that, in addition to selective regional reductions in endogenous aspartate and glutamate,
N-acetylaspartate
(
NAA
), and N-acetylaspartylglutamate (NAAG) are also decreased in the CNS, whereas the activity of N-acetylated-alpha-linked-amino dipeptidase (NAALADase) is increased. In cervical cord, the concentrations of aspartate and glutamate were decreased significantly in the ventral horn;
NAA
was decreased in the ventral horn, dorsal horn and ventral column, whereas NAAG was decreased in all regions of the cord examined, except the posterior column. NAALADase activity was increased in the ventral column. In motor cortex of
ALS
patients, aspartate and glutamate were decreased and NAALADase activity was increased in both gray and white matter; whereas NAAG was decreased in gray matter alone. None of these parameters was affected in the cerebral cortex of the Huntington's patients. Of the markers examined, the alterations in the levels of NAAG most closely parallel the cellular neuropathology in
ALS
.
...
PMID:Reductions in acidic amino acids and N-acetylaspartylglutamate in amyotrophic lateral sclerosis CNS. 168 6
Hereditary canine spinal muscular atrophy (HCSMA) is a lower motor neuron disease found in Brittany Spaniels that shares clinical and pathological features with human
amyotrophic lateral sclerosis
(
ALS
). Since acidic excitatory amino acids and the neuropeptide N-acetyl-aspartyl-glutamate (NAAG) are reduced in spinal cord and cerebral cortex in
ALS
, the levels of these substances were measured in nervous tissue in Brittany Spaniels heterozygous and homozygous for HCSMA. Significant reductions in the levels of endogenous aspartate, glutamate,
N-acetylaspartate
(
NAA
), and NAAG were found in the spinal cord in homozygous but not heterozygous HCSMA. In contrast, the activity of N-acetylated-alpha-linked-amino dipeptidase (NAALADase), an enzyme that cleaves NAAG into
NAA
and Glu, was significantly increased. None of these parameters was affected in the motor cortex or occipital cortex. Since
NAA
and NAAG are highly concentrated in motoneurons, they may play a role in the pathogenesis of motor neuron disease.
...
PMID:Abnormal acidic amino acids and N-acetylaspartylglutamate in hereditary canine motoneuron disease. 811 34
There is mounting evidence, primarily from research in experimental animals, that the dipeptide N-acetylaspartylglutamate (NAAG) and its metabolic enzyme, N-acetylated alpha-linked acid dipeptidase (NAALADase), are involved in glutamatergic neurotransmission. Previous studies in neuropsychiatric disorders associated with the dysregulation of glutamatergic neurotransmission, such as schizophrenia, seizure disorders, and
amyotrophic lateral sclerosis
(
ALS
), have revealed region-specific alterations in the levels of NAAG and in the activity of NAALADase. To establish better the cellular localization of these and related parameters in human brain, we have examined their alterations in two well-characterized selective neurodengenerative disorders, Huntington Disease (HD) and Alzheimer Disease (AD). Brain regions from postmortem controls and HD- or AD-affected individuals were assayed to determine the activity of NAALADase as well as the levels of NAAG,
N-acetylaspartate
(
NAA
), and several amino acids. The relationships between changes in these neurochemical parameters and changes in neuronal and glial cell density were determined. The present report demonstrates that the decreases in the levels of NAAG and
NAA
and in the activity of NAALADase in AD and HD brain correlate primarily with neuronal loss. By inference, the results suggest that NAAG and
NAA
have primarily a neuronal localization in human brain and that there is a close relationship between NAAG and the dipeptidase NAALADase in populations of affected neurons.
...
PMID:N-acetylaspartylglutamate, N-acetylaspartate, and N-acetylated alpha-linked acidic dipeptidase in human brain and their alterations in Huntington and Alzheimer's diseases. 937 25
In vivo proton magnetic resonance spectroscopy (MRS) may be used to quantify brainstem neuronal degeneration in
ALS
because of the neuronal localization of
N-acetylaspartate
and N-acetylaspartylglutamate, together termed NA, which are estimated with this technique. We measured the ratio of NA to creatine/phosphocreatine (NA/Cr) with proton MRS at 3.0 tesla (T) in a 4.3-cm3 volume in the pons and upper medulla of 12
ALS
patients and 17 age-matched control subjects. Brainstem NA/Cr was reduced in
ALS
versus control subjects (mean +/- SD: 1.57 +/- 0.20 versus 1.95 +/- 0.14; p < 0.0001). Patients with severe spasticity or prominent bulbar weakness had the lowest NA/Cr ratios; those with predominantly lower motor neuron limb weakness had near-normal ratios. We conclude that proton MRS may quantify region-specific neuronal dysfunction in
ALS
.
...
PMID:Estimation of brainstem neuronal loss in amyotrophic lateral sclerosis with in vivo proton magnetic resonance spectroscopy. 944 60
The primary objectives of this study were to test whether 1)
N-acetylaspartate
(
NAA
), a neuronal marker, is reduced in motor cortex and corticospinal-tract (CST) brain regions of
ALS
patients; and 2) motor cortex
NAA
correlates to a clinical measurement of upper motor neuron function in
ALS
patients. Ten probable or definite
ALS
patients and nine neurologically normal control subjects were studied. Three axial planes of two-dimensional 1H MRSI data were collected, using a single spin-echo multislice sequence (TE140/TR2000). Two of the 1H MRSI planes were positioned superior to the lateral ventricles, and one plane was positioned at the level of the internal capsule. Spectroscopy voxels were selected from motor cortex, frontal cortex, parietal cortex, medial gray matter, centrum semiovale white matter, anterior internal capsule, and posterior internal capsule. Peak integrals were obtained for the three major 1H MRSI singlet resonances,
NAA
, creatine and phosphocreatine (Cr), and cholines (Cho). Maximum finger-tap rate was used as a clinical measurement of upper motor neuron function. In
ALS
, brain
NAA
/(Cho+Cr) was reduced 19% (p=0.024) in the motor cortex and 16% (p=0.021) in the CST (centrum semiovale and posterior internal capsule) regions.
NAA
/ (Cho+Cr) was not reduced in frontal cortex, parietal cortex, medial gray matter, or anterior internal capsule. There was a significant relation between
ALS
motor cortex
NAA
/(Cho+Cr) and maximum finger-tap rate (r=0.80; p=0.014).
NAA
/(Cho+Cr) was reduced in motor cortex and CST regions and unchanged in other brain regions of
ALS
patients when compared with controls. These findings are consistent with the known distribution of neuronal loss in
ALS
. The positive correlation between motor cortex
NAA
/(Cho+Cr) and maximum finger-tap rate suggests that reduced
NAA
/(Cho+Cr) is a surrogate marker of motor cortex neuron loss in
ALS
. These findings support the study of 1H MRSI
NAA
measurement as an objective and quantitative measurement of upper motor neuron dysfunction in
ALS
.
...
PMID:Decreased N-acetylaspartate in motor cortex and corticospinal tract in ALS. 963 31
Riluzole, a glutamate antagonist, has been shown to be efficacious in the treatment of patients with
amyotrophic lateral sclerosis
(
ALS
), allowing prolonged survival and time to tracheostomy. The efficacy of riluzole in thought to result from reduced glutamate excitotoxicity on motor neurons of patients with
ALS
, but this has never been demonstrated directly in vivo.
N-acetylaspartate
(
NAA
), a compound that is readily measured in vivo using proton magnetic resonance spectroscopy, can be used as a surrogate marker for neuronal loss or sublethal injury. To determine whether riluzole reverses sublethal corticomotoneuron damage in patients with
ALS
we measured
NAA
/creatine (Cr) relative intensity ratios in the motor cortex before and after treatment with riluzole 50 mg bid. After 3 weeks of riluzole therapy in 11 patients
NAA
/Cr increased from 2.14 +/- 0.26 to 2.27 +/- 0.24 (p = 0.044), whereas, in 12 untreated patients
NAA
/Cr decreased from 2.17 +/- 0.20 to 2.08 +/- 0.20 (p = 0.099). Thus the change in
NAA
/Cr between the treated and untreated groups was 0.22 +/- 0.095 (p = 0.008). The magnitude of increase in
NAA
/Cr in those treated was not correlated with age, sex, duration of treatment or disease, the presence of probable or definite upper motor neuron (UMN) signs, bulbar features, or pre-treatment
NAA
/Cr. We conclude that magnetic resonance spectroscopy can provide a novel surrogate measure of neuronal integrity that demonstrates reversal of sublethal UMN injury in patients with
ALS
within weeks of initiating riluzole therapy.
...
PMID:Recovery of N-acetylaspartate in corticomotor neurons of patients with ALS after riluzole therapy. 966 96
Proton magnetic resonance spectroscopy (1H-MRS) was used to measure the in vivo signal of
N-acetylaspartate
(
NAA
), a putative neuronal marker, in the brain of the mutant wobbler mouse, a model of motor neuron disease. The ratio of
NAA
to creatine-phosphocreatine, an internal standard, was significantly lower in five affected wobbler mice (0.79+/-0.05; mean+/-s.d.) than in five unaffected littermates (0.98+/-0.10, p = 0.006). Ubiquitin and phosphorylated heavy neurofilament immunoreactivities were increased in cortical neurons of affected animals. This is the first demonstration of cerebral neuronal pathology in the wobbler mouse, supporting its use as a model of
amyotrophic lateral sclerosis
. In vivo IH-MRS and correlative postmortem study of wobbler mouse brain will allow temporal monitoring of neuronal degeneration and responsiveness to neuroprotective pharmacotherapies.
...
PMID:Neuronal pathology in the wobbler mouse brain revealed by in vivo proton magnetic resonance spectroscopy and immunocytochemistry. 980 13
Prostate-specific membrane antigen (PSMA) is a 100 kDa type II transmembrane protein with folate hydrolase and NAALAdase activity. PSMA is highly expressed in prostate cancer and the vasculature of most solid tumors, and is currently the target of a number of diagnostic and therapeutic strategies. PSMA is also expressed in the brain, and is involved in conversion of the major neurotransmitter NAAG (N-acetyl-aspartyl glutamate) to
NAA
and free glutamate, the levels of which are disrupted in several neurological disorders including multiple sclerosis,
amyotrophic lateral sclerosis
, Alzheimer's disease and schizophrenia. To facilitate analysis of the role of PSMA in carcinoma we have determined the structural organization of the gene. The gene consists of 19 exons spanning approximately 60 kb of genomic DNA. A 1244 nt portion of the 5' region of the PSMA gene was able to drive the firefly luciferase reporter gene in prostate but not breast-derived cell lines. We have mapped the gene encoding PSMA to 11p11-p12, however a gene homologous, but not identical, to PSMA exists on chromosome 11q14. Analysis of sequence differences between non-coding regions of the two genes suggests duplication and divergence occurred 22 million years ago.
...
PMID:Mapping, genomic organization and promoter analysis of the human prostate-specific membrane antigen gene. 983 72
The care of patients with
amyotrophic lateral sclerosis
(
ALS
), which has classically focused on treatment of symptomatology, has now entered an encouraging new era of therapy targeted at the pathophysiology of the disease. However, an objective measure of disease progression and therapeutic response is sorely needed. Quantitative neuromuscular examinations, measurement of pulmonary function, disability scales, and even survival, are limited by variability due to a number of poorly controlled factors. Quantitative electromyography, positron emission tomography scanning, and magnetic cortical stimulation, provide potential objective indicators of disease progression, but require a large number of patients and a long observation period for adequate statistical power. We have examined the role of magnetic resonance spectroscopic imaging in detecting acute changes in motor cortical metabolism in response to riluzole therapy.
N-acetylaspartate
(
NAA
), the most prominent signal in proton spectra of normal brain, is a neuron-specific molecule.
ALS
patients were found to experience a significant increase in the
NAA
/creatine ratio within 3 weeks of initiation of riluzole therapy. As glutamate can trigger the generation of reactive oxygen species in neurons, we speculate that acute changes in
NAA
levels may reflect oxidative injury to mitochondria where
NAA
is synthesised. The advent of a useful test for upper motor neuron metabolic compromise may provide an objective, non-invasive, short duration measure with which to screen the efficacy of potential therapeutic agents for
ALS
.
...
PMID:Biological markers in the diagnosis and treatment of ALS. 1044 78
We aimed to increase confidence in the combined use of MRI and proton MR spectroscopy (1H-MRS) in diagnosis of
amyotrophic lateral sclerosis
(
ALS
). We investigated 12 patients with
ALS
, seven definite and five probable, taking into account clinical measures of motor neuron function. On T2-weighted images we found high signal in the corticospinal tract in six and low signal in the primary motor cortex in seven of the 12 patients. Atrophy of the precentral gyrus was apparent in all the patients apart from one with probable
ALS
. Absolute quantification of cerebral metabolites using 1H-MRS demonstrated a significantly lower mean concentration of
N-acetylaspartate
(
NAA
) in the precentral gyrus of patients with probable and definite
ALS
(8.5 +/- 0.62) than in control subjects (10.4 +/- 0.71; P < 0.001).
NAA
concentration in primary motor cortex correlated with Norris scale scores (r = 0.30; P < 0.0001) but not with the
ALS
Functional Rating Scale score or disease duration. Significantly lower levels of
NAA
were detected in patients with low signal in the motor cortex than in those without (P < 0.01). Mean choline (Cho) and creatine (Cr) values did not differ between patients with
ALS
and controls.
...
PMID:Magnetic resonance imaging and 1H-magnetic resonance spectroscopy in amyotrophic lateral sclerosis. 1130 49
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