Study Of Proton Magnetic Resonance Spectroscopy In The Early Diagnosis Of Parkinson's Disease

ObjectiveParkinson's Disease(PD)is consider to be a movement disorder which includes a group of symptoms such as tremor,rigidity,bradykinesia and gait disorder associated with postural instability.For the moment,The final diagnosis of Parkinson's disease is rely mainly on its clinical diagnosis which is restricted,for the clinic diagnosis is not completely coincident with the pathologic diagnosis.Therefore,we need some other auxiliary examinations to raise the rate of the final diagnosis.We discuss the value of the ¹H-MRS in the diagnosis of PD by studying the data of the Proton magnetic resonance spectroscopy and then analyse the pathological mechanisms of PD which can support our study.By means of the study,we hope that we can raise the rate of the final diagnosis and detect the PD patients who are in the incubation period of the disease.Therefore,we can do early intervention to PD in order to improve the quality of PD patients's life.Methods1.45 IPD patients were recruited in this study.And these patients were from Qilu Hospital.The diagnosis of PD referred to the UK PD Brain Bank criteria.The patients are only have unilateral symptom and all of them are ruled out with serious mental illness and other complications.The patients of the comparison group included 30 patients who are Ruled out with mental and neurological disorders and proved to be health by the brain magnetic resonance imaging. 2.All patients with Parkinson's disease and normal comparison group patients received general information on the questionnaire,including age,sex,education,living environment,whether contacting with toxic substances,and the course of Parkinson's disease,the first symptom,the details of taking drugs.All the PD patients were graded according to UPDRS and Hoehn & Yahr staging.3.Adoptting GE EXCITEâ…¡Signa 3.0T magnetic resonance of Shandong university Qilu Hospital,we first routinly scan T₁WI,T₂WI and T₂Flair as routine, exclude brain parenchymal disease.We use 8 passages as launch and receive coil in ¹H-MRS,made canthomeatal line as time base to gather normal axial view T₁WI image for location.We use PROBE-J sequence to carry out simple voxel collection and the initiation state is TE=35ms,TR=2000ms,NEX=6,FOV=24,to collect matrix 1x1.Region of interest(ROI)is in both Basal ganglias,in which we choose up and down,left and right,and anteroposterior diameter to discern 15min×15min×15mm.After scanning,we made after-processing in the main frame using SAGE software.Then we can get wave spectrum curve,areas of each metabolin,and calculate ratio of the areas below the ratio of NAA/Cr,MI/Cr,Cho/Cr summit.(NAA:N-acetylaspartate;Cho:choline;Cr:creatine).4.Statistic Manual:The data were analyzed using SPSS 10.0 for Windows (Chicago,IL)t-test,and the results are Expressed with Mean±standard deviation ((?)±SD).ResultsThere was no significant statistics between both Basal ganglias in comparison group.The ratio of NAA/Cr,Cho/Cr and NAA/Cho are significant discrepancy between each basal ganglia in PD group;The ratio of NAA/Cr,Cho/Cr and NAA/Cho are significant discrepancy between the Contralateral basal ganglia of affected extremity in PD group and the basal ganglia in comparison group;The ratio of NAA/Cr,Cho/Cr and NAA/Cho are significant discrepancy between the Ipsilateral basal ganglia of affected extremity in PD group and the basal ganglia in comparison group. ConclusionBy means of the study,we conclude that ¹H-MRS play a role in the early diagnosis of PD.Furthermore,as the ratio of NAA/Cr,Cho/Cr and NAA/Cho are significant discrepancy between the Ipsilateral basal ganglia of affected extremity in PD group and the basal ganglia in comparison group,we conclude that the ¹H-MRS can help us to chect out the PD patients who are in the incubation period of the disease.¹H-MRS is a useful tool for early or sub-clinical diagnosis of Parkinson's disease.