Proton magnetic resonance spectroscopy (H-1-MRS) in ALS

Establishing the presence of upper motor neuron (UMN) pathology is essentia l for an accurate and definite diagnosis of ALS, However, clinical identifi cation of UMN dysfunction can be difficult in early disease or if lower mot or neuron signs are prominent. A routine technique such as magnetic resonan ce imaging is usually normal and non-specific. Proton magnetic resonance sp ectroscopy (H-1-MRS) is a non-invasive neuroimaging technique that has succ essfully demonstrated evidence of neuronal abnormalities in motor regions o f the brain in ALS. This review discusses the advantages and limitations of employing H-1-MRS as an investigative tool in the diagnosis of ALS.