Study Of Parkinson’s Disease With Proton Magnetic Resonance Spectroscopy

Objective:To investigate the metabolite alteration in putamen and substantia nigra in Patients with Parkinson’s disease and evaluate the meaning of metabolite alterationMethods:54 patients with Parkinson’s disease and 61 age-and gender-matched healthy controls were included in this study,all patients were rated on the UPDRS and Hoehn&Yahr scale,All subjects were scanned by the single-voxel 1H-MRS with 30mmx40mmx25mm voxel in the bilateral putamen and substantia nigra.Then the software attached to the equipment automatically identifies and calculates N-acetylaspartate/creatine(NAA/Cr),choline/creatine(Cho/Cr)and gamma-aminobutyric acid/creatine(GABA/Cr).Results:Compare to the healthy controls,The ratios of NAA/Cr of the putamen and substantia nigra contralateral to the worst affected side in patients with are reduced significantly.To the contrary,the ratios of CHO/Cr and GABA/Cr of the putamen contralateral to the worst affected side in patients with PD are increased significantly.In addition,the ratio of GABA/Cr of the putamen ipsilateral to the worst affected side is increased significantly compare to the healthy participants.Among patients with PD,compared to the ipsilateral putamen,the ratio of NAA/Cr of the contralateral putamen is reduced significantly.But it has no differences between the ratios of CHO/Cr and GABA/Cr in bilateral putamen in patients with PD.In asymmetrical symptom patients,the ratio of NAA/Cr of contralateral putamen which are under 2.5 stage by Hoehn&Yahr is reduced significantly compare to the patients who are above 3 stage by Hoehn&Yahr.Further more,the ratio of NAA/Cr of contralateral putamen which are under 2.5 stage by Hoehn&Yahr is reduced significantly compare to the healthy controls.However no other differences of metabolite alterations were discovered between patients-and healthy participants.Patients with PD who take Levodopa and patients without taking Levodopa show a similar ratio of NAA/Cr CHO/Cr and GABA/Cr.Repeated analysis of variable shows that no correlation was exists between the ratio of metabolite in patients with PD and the UPDRS score or the time since PD onset.Conclusion:The proton magnetic resonance spectroscopy is a valuable tool to detect the metabolic changes none invasive in patients with Parkinson’s disease.The metabolite alterations of NAA/Cr、CHO/Cr and GABA/Cr can assist to diagnose PD,especially the ratio of NAA/Cr in putamen play a valuable role in early diagnose.The degeneration of neuron of patients with PD maybe occur more earlier than Parkinson’s symptom.The balance between exciting neurotransmitter and inhibiting neurotransmitter may another mechanism of PD.We can not infer that1 H-MRS can evaluate the benefit of taking Levodopa among patients with PD.There is no relationship between the metabolite alterations and UPDRS score or the time since PD onset.