Article

Proton magnetic resonance spectroscopic imaging in progressive supranuclear palsy, Parkinson's disease and corticobasal degeneration

Neuroimaging Branch, NINDS, National Institutes of Health, Bethesda, MD, USA.
Brain (Impact Factor: 10.23). 10/1997; 120 ( Pt 9)(9):1541-52. DOI: 10.1093/brain/120.9.1541
Source: PubMed

ABSTRACT We used proton magnetic resonance spectroscopic imaging (1H-MRSI) to assess the in vivo cortical and subcortical neuronal involvement in progressive supranuclear palsy, Parkinson's disease and corticobasal degeneration. This technique permitted the simultaneous measurement of compounds containing N-acetylaspartate (NA), choline (Cho), creatine-phosphocreatine (Cre) and lactate, from four 15-mm slices divided into 0.84-ml single-volume elements. The study included 12 patients with progressive supranuclear palsy, 10 with Parkinson's disease, nine with corticobasal degeneration and 11 age-matched normal control subjects. Regions of interest were selected from the brainstem, caudate, thalamus, lentiform nucleus, centrum semiovale, and from frontal, parietal, precentral, temporal and occipital cortices. Progressive supranuclear palsy patients, compared with control subjects, had significantly reduced NA/Cre in the brainstem, centrum semiovale, frontal and precentral cortex, and significantly reduced NA/Cho in the lentiform nucleus. Corticobasal degeneration patients, compared with control subjects, had significantly reduced NA/Cre in the centrum semiovale, and significantly reduced NA/Cho in the lentiform nucleus and parietal cortex. There were no significant differences between Parkinson's disease patients and control subjects, or between patients groups in any individual region of interest. In the parietal cortex of corticobasal degeneration patients, NA/Cho was significantly reduced contralateral to the most affected side. There were statistically significant group differences in the regional pattern of NA/Cre and NA/Cho reduction, comparing normal control subjects with all patient groups, Parkinson's disease with corticobasal degeneration, and Parkinson's disease with progressive supranuclear palsy. Although the occurrence of significant groups differences does not imply that it is possible to differentiate between individual patients using 1H-MRSI in progressive supranuclear palsy and corticobasal degeneration, detection of specific cortical and subcortical patterns of neuronal involvement is possible with this technique. We suggest that this regional pattern of neuronal involvement found in progressive supranuclear palsy and corticobasal degeneration may help in the diagnostic evaluation of affected individuals.

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    • "Some studies reported no metabolite differences between the PD patients and the control subjects in either metabolite ratios or absolute concentration of NAA, Cho, and Cr in cortical-basal ganglia loop [17–20]. A 1H-MRSI study of Tedeschi et al. [19] found that there were no significant differences between PD patients and control subjects of NAA, Cho, and Cr ratios in brainstem, caudate, thalamus, lentiform nucleus, and association cortices. These findings were in agreement with previous single-voxel 1H-MRS studies that showed no significantly reduced NAA in lentiform nucleus [17] and putamen and thalamus [18]. "
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    ABSTRACT: Parkinson's disease (PD) is a neurodegenerative disorder caused by selective loss of dopaminergic neurons in the substantia nigra pars compacta which leads to dysfunction of cerebral pathways critical for the control of movements. The diagnosis of PD is based on motor symptoms, such as bradykinesia, akinesia, muscular rigidity, postural instability, and resting tremor, which are evident only after the degeneration of a significant number of dopaminergic neurons. Currently, a marker for early diagnosis of PD is still not available. Consequently, also the development of disease-modifying therapies is a challenge. Magnetic resonance spectroscopy is a quantitative imaging technique that allows in vivo measurement of certain neurometabolites and may produce biomarkers that reflect metabolic dysfunctions and irreversible neuronal damage. This review summarizes the abnormalities of cerebral metabolites found in MRS studies performed in patients with PD and other forms of parkinsonism. In addition, we discuss the potential role of MRS as in vivo molecular imaging biomarker for early diagnosis of PD and for monitoring the efficacy of therapeutic interventions.
    BioMed Research International 09/2014; 2014:519816. DOI:10.1155/2014/519816 · 2.71 Impact Factor
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    • "By application of 1 H-MRSI statistically significant difference in regional patterns of the NAA/Cr and NAA/Cho ratios between patients with PD and those with CBD and between patients with PD and those with PSP was found (Tedeschi et al., 1997). Other 1 H-MRS examinations didn't show significant difference between the PD patients and the control subjects (Tedeschi et al., 1997), also in the striatum (Holshouser et al., 1995), in the putamen and globus pallidus (Federico et al., 1997), and in occipital lobe (Bowen et al., 1995). The NAA/Cho and NAA/Cr ratios were significantly reduced in the putamen and globus pallidus of MSA and the PSP patients, in which neuronal loss involves, compared with the control subjects (Federico et al., 1997). "
    Diagnostics and Rehabilitation of Parkinson's Disease, 12/2011; , ISBN: 978-953-307-791-8
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    • "Earlier magnetic resonance imaging (MRI) studies have primarily used regions of interest analyses to examine brain atrophy [7, 8, 9, 10, 11]. However, the results of such analyses depend largely on the arbitrary locus and size that examiners select retrospectively. "
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    ABSTRACT: The aim of this study was to compare differences in morphological and functional changes in brain regions in individual patients with progressive supranuclear palsy (PSP) and correlate their Mini-Mental State Examination (MMSE) score with anatomy and function using magnetic resonance imaging (MRI) and (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET). Sixteen PSP patients and 20 age-matched healthy volunteers underwent FDG-PET and 3-dimensional MRI. Gray matter, white matter and metabolic activity were compared between patients and normal controls. In addition, possible correlations between the MMSE score and brain function/anatomy were examined. The PSP group had reduced cerebral glucose metabolism, and lower gray and white matter volumes in the frontal lobes and midbrain compared with normal controls. In PSP subjects, the metabolic changes observed in the PET scans were greater than the loss in gray and white matter observed in the MRI scans. The MMSE scores were positively correlated with volume and FDG uptake in the frontal lobe. FDG-PET is a more effective tool in the diagnosis of PSP than MRI. Atrophy and hypometabolism in the frontal lobe are as important as in the basal midbrain for differentiating PSP patients who primarily exhibit cognitive dysfunction from normal controls.
    11/2011; 1(1):381-92. DOI:10.1159/000333368
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