The Study Of ～1H Magnetic Resonance Spectroscopy In Parkinson Disease

Objective To evaluate the utility of the hydrogen proton magnetic resonancespectroscopy in the metabolism of the putamen, substantia nigra, frontal lobe and hippocampus in patients with Parkinson disease.Sudjects and Methods 65 patients with Parkinson disease and 38 age andsex matched healthy controls were admitted. The patients with Parkinson disease were assessed using unified Parkinson disease rating scale (UPDRS) and mini-mental state examination (MMSE), and the control groups were undergone the MMSE. All of them underwent the multvoxel proton magnetic resonance spectroscopic (~1H MRS) collection in the areas of the putamen, substantia nigra, frontal lobe and hippocampus. There were 46 patients with Parkinson disease and 30 controls in the groups of the putamen.There were 56 patients with Parkinson disease and 30 controls in the group of the substantia nigra. There were 20 patients with Parkinson disease and 20 controls in the group of the frontal lobe.There were 37 patients with Parkinson disease and 20 controls in the group of the hippocampus. To analysis the ~1H MRS results of the patients with Parkinson disease and controls, and the relationship between the ~1H MRS results and scored of UPDRS, MMSE, H&Y stage and disease duration.Results There was a significant reduction in NAA/Cr ratios in contralateralputamen to the worst clinically affected limbs of the patients with Parkinson disease compared with ipsilateral putamen and controls (P0.05). There was a significantreduction in NAA/Cr ratios in the asymptomatic sides of putamen in Parkinson disease with unilateral symptoms compared with controls (PO.05). There was a significant reduction in NAA/Cr ratios in contralateral putamen to the worst clinically affected limbs of the patients with Parkinson disease in untreated group compared with those patients in dopamine preparation treated group and controls.(P<0.05) There were no significant difference in NAA/Cr, Cho/Cr, NAA/Cho ratios in substantia nigra between the patients with Parkinson disease and controls. There was a significant reduction in NAA/Cr ratios in contralateral frontal lobe to the worst clinically affected limbs of the patients with Parkinson disease whose H&Y stage abose III compared with the patients who had mild symptoms and the controls (PO.05). Ml/Cr ratios in the left hippocampus in non-demented patients with Parkinson disease were significantly higher compared with the right side and the controls (P<0.05),there was no significant difference in NAA/Cr ratio in the two groups.There was no significant difference in NAA/Cho and Cho/Cr ratios between patients with Parkinson disease and controls for any of the regions.No significant correlation was found between any of the measured ratios and motor disability ,MMSE and disease duration.Conclusions1. *H MRS is a valuable tool to detect the metabolic changes in the PD, supports the changes of anatomy in images.2. *H MRS can detect the reduction of the NAA/Cr ratios in early stage of PD,which give the help to early diagnosis.3. NAA/Cr ratios in the putamen is affected by the dopamine preparation , and NAA/Cr ratios can provid a reversible marker of neuronal dysfunction in the striatum.4. JH MRS can not show the metabolic changes precisely in the substantia nigra in patients with Parkinson disease.5. There was a significant reduction in NAA/Cr ratios in the frontal lobe of severe patients with Parkinson disease compared with the mild patients and controls,which is helpful to predict the state of the illness..6. *H MRS can detect metabolic changes in hippocampus in the non-demented patients with Parkinson disease , do help to the diagnosis of etiology and prediction of the risk.7. There haven't any reports on !H MRS in frontal lobe and hippocampus in patients with Parkinson disease in home.and there have few studies in this field abroad.Our study established the theoretic foundation on research deeply in neurobiochemical changes and prognosis in patients with Parkinson disease.