帕金森病患者基底节区质子磁共振波谱研究

Proton magnetic resonance spectroscopy of putamen and substantia nigra in patients with Parkinson disease

目的利用氢质子磁共振波谱(1H MRS)技术研究帕金森病(PD)患者基底节区(壳核、黑质)的代谢变化及意义。方法PD患者58例和正常对照40例行1H MRS检查,测定双侧壳核的N-乙酰天冬氨酸/肌酸(NAA/Cr)、N-乙酰天冬氨酸/胆碱复合物(NAA/Cho)和胆碱复合物/肌酸(Cho/Cr)比值。结果PD患者症状严重侧肢体的对侧壳核NAA/Cr比值与同侧及对照组相比均明显降低(P<0.05),症状严重侧肢体的对侧壳核NAA/Cr比值为1.406±0.159,同侧为1.502±0.446,对照组为1.539±0.243。而PD患者症状严重侧肢体的对侧壳核Cho/Cr比值、NAA/Cho比值与同侧及对照组相比,差异无统计学意义(P>0.05);PD患者症状严重侧肢体的对侧黑质的NAA/Cr、Cho/Cr和NAA/Cho比值与同侧及对照组相比差异均无统计学意义(P>0.05)。结论1H MRS可以检测到PD患者壳核的NAA/Cr比值降低,这有助于PD的诊断;目前的1H MRS技术尚不能精准地反应PD患者黑质的代谢变化。

Objective To evaluate the utility of the hydrogen proton magnetic resonance spectroscopy （^1H MRS） in the metabolism of the putamen and substantia nigra in patients with Parkinson disease. Methods ^1H MRS was administered to 58 patients with Parkinson disease, and 40 volunteers, N-acetylaspartic acid/creatine（NAA/Cr）, N-acetylaspartic acid/choline（NAA/Cho） ,and choline/creatine（Cho/Cr） in bilateral putamen and substantia nigra were determined. Results There was a significant reduction in NAA/Cr ratio in contralateral putamen to the worst clinically affected limbs of the patients with Parkinson disease compared with ipsilateral putamen and controls （P〈0.05）. NAA/ Cr ratio in contralateral putamen was 1. 406 ± 0. 159, NAA/Cr ratios in ipsilateral putamen 1. 502±0.446, and NAA/Cr ratios in controls 1. 539 ± 0. 243. There were no significant difference in NAA/Cr, Cho/Cr, NAA/Cho ratio in substantia nigra between the patients with Parkinson disease and controls （ P 〉 0.05）. Conclusion ^1H MRS can detect the reduction of the NAA/Cr ratio in Parkinson disease, which helps to Parkinson disease diagnosis. ^1H MRS can not show the metabolic changes precisely in the substantia nigra in patients with Parkinson disease.