1H-MRS检测早期帕金森病纹状体、黑质的功能代谢

Metabolic changes of striatum and substantia nigra in patients with early Parkinson＇s disease demonstrated by 1H-MRS

目的探讨1H-MRS检测早期帕金森病(PD)患者纹状体和黑质代谢变化的可能性。材料与方法 44例经临床确诊的双侧肢体症状不伴痴呆的早期PD患者纳入研究,32名年龄、性别等相匹配的健康志愿者作为对照组,两组均进行纹状体单体素1H-MRS及黑质多体素1H-MRS检查。PD患者33例获得纹状体MRS谱线,32例获得黑质MRS谱线;志愿者31名获得双侧纹状体MRS谱线,28名获得双侧黑质谱线。测量豆状核、黑质区域NAA、Cho、Cr及各参数比值,并进行比较分析。结果 PD组及对照组左右侧纹状体、黑质NAA、Cho、Cr各参数比值的差异均无统计学意义(P值均>0.05)。PD组纹状体NAA/Cr较对照组降低(P<0.05),其余各参数比值与对照组无明显差异(P>0.05);黑质各参数值两组间的差异无统计学意义(P值均>0.05)。结论 1H-MRS能检测双侧症状不伴痴呆的早期PD患者纹状体代谢异常,有助于早期PD的诊断。

Objective： To investigate whether ＇H-MRS can be used to demonstrate the metabolic changes in striatum and substantia nigra for early Parkinson＇s disease （PD）. Materials and Methods： Totally, 44 patients with early Parkinson＇s disease having bilateral symptoms but without dementia were enrolled. Thirty-two age and sex-matched volunteers were included as normal controls. ~H-MRS using single- voxel PRESS for the striatum and multiple-voxel PRESS for the substantia nigra were performed. MRS data were successfully obtained from the striatum in 33 patients and the substantia nigra in 32 patients, and respectively from 31 and 28 volunteers. The metabolite contents, including N-acetylaspartete （NAA）, Choline （Cho）, Creatinine （Cr） and their relative ratios were analyzed and compared. Results： No significant differences were found for each ratio of metabolite contents between right and left in striatum and substantia nigra either in the patients or in the controls （P〉0.05）. The NAA/Cr ratio of the striatum was lower in the PD patients than that in controls （P〈0.05）, but no significant differences were found in other ratios （P〉0.05）. In the substantia nigra, there were no significant differences for all metabolite content ratios between the two groups （P〉0.05）. Conclusions： 1H-MRS can be used to detect the metabolic abnormality in striatum for early PD with bilateral symptoms without dementia, which is helpful for the early diagnosis of PD.