The Usage of Proton Magnetic Resonance Spectroscopy in Parkinson’s Disease

Pichest Metarugcheep MD*, Suchat Hanchaiphiboolkul MD**, Akravudh Viriyavejakul MD**, Somsak Chanyawattiwongs MSc*

Affiliation : * MRI Unit, Prasat Neurological Institute, Department of Medical Sevices Ministry of Health, Bangkok, Thailand * Department of Neurology, Prasat Neurological Institute, Department of Medical Sevices, Ministry of Health, Bangkok, Thailand

Background : Parkinson’s disease is a degenerative disorder of the central nervous system resulting from neuronal loss in the substantia nigra (a region of the mid brain) and BSG. Proton magnetic resonance spectroscopy (1H-MRS) has been previously performed in Parkinson’s disease (PD) to evaluate in vivo concentration of basal ganglia (BSG) and cerebral cortex metabolites. However, this technique has never been used to evaluate the substantia nigra (SN) in PD patients. In this preliminary report, single voxel MRS of BSG and SN was performed in PD and normal control (non-PD) to evaluate the usage of MRS in PD patients Material and Method: Seventeen PD patients including 12 men and fi ve women with a mean age 60.5 years (SD 9.4) and a mean duration of the disease 5.9 years (SD 4.2) based on Hoehn & Yahr stage I to III, and 14 healthy age-matched controls including eight men and six women with a mean age 55.5 years (SD 5.8) were enrolled. Patients with evidence of brain atrophy and cognitive impairment were excluded.
Results : A signifi cant reduction in the NAA/Cr ratio was observed in the SN of PD compared with controls (p < 0.05). BSG spectra did not allow any evaluation due to the presence of artifacts related to inorganic paramagnetic substances.
Conclusion : 1H-MRS could be used as a sensitive tool for studying neuronal dysfunction in SN of PD patients and may be a useful technique to monitor the disease. The SN reduction of NAA/Cr ratio in PD patients may be the marker of neuronal loss in SN of patients with PD.

Keywords : Parkinson’s disease, Spectroscopic imaging, Substantia nigra

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