| Objective: The changes of metabolites in cerebellum,thalamus and frontal lobe of ET(essential tremor)patients were studied by MRS(magnetic resonance spectroscopy).The MS(motor symptoms)and NMS(non motor symptoms)of ET patients were studied by means of scale evaluation,and the differences in MRS values and NMS scores between ET patients and healthy adults were clarified,The correlation between the age,course of disease and clinical symptom scale score of ET patients,and the correlation between MRS value and age,course of disease and clinical symptom scale score,so as to explore the application value of MRS in clinical research of ET and provide imaging support for early diagnosis of ET.Methods: From October 2021 to September 2022,40 patients diagnosed as ET in the department of neurology of the Affiliated Hospital of Inner Mongolia Medical University were selected as the research objects.The age of onset was no more than 60 years old,and the course of disease was more than 3 years.At the same time,40 healthy adults were selected as HC(health control,healthy control group).The ET patients were scored with TETRAS(Tremor Research Group Essential Tremor Rating Assessment Scale),and the two groups of subjects were evaluated with TAS-20(Toronto Alexithymia Scale),Mo CA(Montreal cognitive assessment scale),HAMD(Hamilton depression scale)and MRS.Observe the metabolite ratio(NAA/Cr,NAA/Cho,Cho/Cr)of cerebellum,thalamus and frontal lobe and NMS score of the two groups of subjects,understand the relevant factors of MRS value changes,and analyze with statistical methods.Results: The score of TAS-20 and HAMD in ET group was higher than that in HC group,while the score of Mo CA was lower than that in HC group,with statistically significant difference(P<0.05).In ET group,the NAA/Cr ratio in the area of interest in the cerebellum of the relevant side and the NAA/Cr and NAA/Cho ratio in the area of interest in the frontal lobe of the relevant side were significantly lower than those in the non-related side(P<0.05);There was no significant difference in the ratio of other metabolites in the regions of interest of bilateral cerebellum,thalamus and frontal lobe(P>0.05).The ratios of NAA/Cr,NAA/Cho and Cho/Cr in the cerebellum of interest of the related and non-related sides in ET group were significantly lower than those in HC group(P<0.05);The NAA/Cr,Cho/Cr ratio and NAA/Cho ratio in the area of interest of the frontal lobe of the related side and the non-related side in the ET group were significantly lower than those in the HC group(P<0.05);There was no significant difference in the ratio of NAA/Cr,NAA/Cho,Cho/Cr in the area of interest of the bilateral thalamus between ET group and HC group(P>0.05).In ET group,the TETRAS score of patients with family history was higher than that of those without family history,and the NAA/Cr ratio in the area of interest in the cerebellum of the related side was lower,and the difference was statistically significant(P<0.05);There was no significant difference between the scores of NMS scale and the ratio of metabolites in other brain regions of interest(P>0.05).The age of ET group was positively correlated with TETRAS score(r=0.471,P=0.002),and negatively correlated with Mo CA score(r=-0.458,P=0.003);In ET group,the NAA/Cr ratio in the cerebellum of the related side was moderately negatively correlated with age,slightly negatively correlated with TETRAS score(r=-0.483,P=0.002;r=-0.354,P=0.025),and slightly positively correlated with Mo CA score(r=0.358,P=0.024);In ET group,the NAA/Cr ratio of unrelated cerebellum,the NAA/Cho ratio of related cerebellum and the NAA/Cr ratio of related frontal lobe were negatively correlated with age(r=-0.458,P=0.003;r=-0.518,P=0.001;r=-0.408,P=0.009);In ET group,the NAA/Cho ratio of unrelated frontal lobe was moderately negatively correlated with age and slightly negatively correlated with TAS-20 score(r=-0.530,P<0.001;r=-0.348,P=0.028);There was no significant correlation between the MRS values in the regions of interest of other brain regions and the scores of age,course of disease and clinical symptom scale.Conclusion: Through MRS detection and clinical symptom scale score of ET patients,it was found that there were statistical differences between the NMS scale score of ET patients and the MRS values of cerebellum and frontal lobe compared with healthy adults in the same period,and the clinical symptoms might be more serious with the age of patients.At the same time,there might be some correlation between the MRS values and the age,clinical symptom scale score.Therefore,MRS is expected to provide imaging support for the diagnosis of ET.We hope that MRS and the scale can be used together in ET to make early diagnosis of ET patients and find their non exercise symptoms as early as possible,so as to improve the quality of life of patients. |
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