Hentschel J, Möckel R, Schlemmer H P, Markus A, Göpel C, Gückel F, Köpke J, Georgi M, Schmidt M H
Abteilung für Neuroradiologie ZI Mannheim, Fakultät für klinische Medizin Mannheim, Universität Heidelberg.
Rofo. 1999 Mar;170(3):284-9. doi: 10.1055/s-2007-1011041.
The neurophysiological and neuromorphological changes in patients with anorexia nervosa (AN) are well-known but the reason of both is still unknown. We have evaluated the usefulness of hydrogen (H1) magnetic resonance spectroscopy in anorexia nervosa.
We investigated 15 patients with clinically diagnosed AN (ICD F50.0) and 17 controls without eating disorders. The body mass index (BMI) was 15.8 and 21, respectively. The spectroscopy was recorded on two voxels in the parieto-occipital white matter or in the thalamus with a water-suppressed STEAM-sequence. The metabolites were recorded with respect to phosphocreatine (PCr).
The ratio of NAA/PCr in both voxels were not significantly different when comparing patients vs. controls. Patients showed significantly higher ratios of choline-containing components (Cho) or, respectively Cho/PCr and NAA/PCr in the white matter. Distinct, but not significant differences were detected both for m-Ino and m-Ino/PCr in the parieto-occipital region and for the Cho- and m-Ino contained ratios in the thalamus.
AN is not associated with neuronal damage. The ratio of Cho/PCr and NAA/Cho may reflect the disturbance of membrane-turnover. It is possible that the increase of membrane catabolism leads to a hyperosmolar state. The change of m-Ino/PCr ratio may reflect the regulation of osmolarity.
神经性厌食症（AN）患者的神经生理和神经形态学变化已为人熟知，但两者的原因仍不清楚。我们评估了氢（H1）磁共振波谱在神经性厌食症中的作用。
我们调查了15例临床诊断为AN（国际疾病分类F50.0）的患者和17例无饮食失调的对照者。体重指数（BMI）分别为15.8和21。采用水抑制STEAM序列在顶枕白质或丘脑中的两个体素上记录波谱。记录相对于磷酸肌酸（PCr）的代谢物。
比较患者与对照者时，两个体素中NAA/PCr的比值无显著差异。患者白质中含胆碱成分（Cho）或分别为Cho/PCr和NAA/PCr的比值显著更高。在顶枕区，m-肌醇和m-肌醇/PCr以及丘脑中含Cho和m-肌醇的比值均检测到明显但不显著的差异。
AN与神经元损伤无关。Cho/PCr和NAA/Cho的比值可能反映膜周转的紊乱。膜分解代谢增加可能导致高渗状态。m-肌醇/PCr比值的变化可能反映渗透压的调节。
