Haley R W, Marshall W W, McDonald G G, Daugherty M A, Petty F, Fleckenstein J L
Dept. of Internal Medicine, Section of Epidemiology, University of Texas Southwestern Medical Center at Dallas, 75390-8874, USA.
Radiology. 2000 Jun;215(3):807-17. doi: 10.1148/radiology.215.3.r00jn48807.
To test for neuronal brain damage in the basal ganglia and brainstem in Gulf War veterans by using magnetic resonance (MR) spectroscopy.
Twenty-two Gulf War veterans with one of three factor analysis-derived syndromes (case patients); 18 well veterans matched for age, sex, and education level (control subjects); and six Gulf War veterans with syndrome 2 from a different population (replication sample) underwent long echo time (272 msec) proton (hydrogen 1) MR spectroscopy on a 4 x 2 x 2-cm voxel in the basal ganglia bilaterally and a 2 x 2 x 2-cm voxel in the pons. Syndromes 1-3 are described as "impaired cognition," "confusion-ataxia," and "central pain," respectively.
The N-acetylaspartate-to-creatine (NAA/Cr) ratio, which reflects functional neuronal mass, was significantly lower in the basal ganglia and brainstem of Gulf War veterans with the three syndromes than in those structures of the control subjects (P =.007). The finding was corroborated in the replication sample (P =.002). Veterans with syndrome 2 (the most severe clinically) had evidence of decreased NAA/Cr in both the basal ganglia and the brainstem; those with syndrome 1, in the basal ganglia only; and those with syndrome 3, in the brainstem only.
Veterans with different Gulf War syndromes have biochemical evidence of neuronal damage in different distributions in the basal ganglia and brainstem.
通过磁共振（MR）波谱分析检测海湾战争退伍军人基底神经节和脑干的神经元脑损伤情况。
22名患有三种因子分析得出的综合征之一的海湾战争退伍军人（病例组）；18名年龄、性别和教育水平相匹配的健康退伍军人（对照组）；以及6名来自不同人群的患有综合征2的海湾战争退伍军人（重复样本），在双侧基底神经节的一个4×2×2厘米的体素以及脑桥的一个2×2×2厘米的体素上进行了长回波时间（272毫秒）的质子（氢1）MR波谱分析。综合征1 - 3分别被描述为“认知受损”、“混乱性共济失调”和“中枢性疼痛”。
反映功能性神经元数量的N - 乙酰天门冬氨酸与肌酸（NAA/Cr）比值，在患有这三种综合征的海湾战争退伍军人的基底神经节和脑干中显著低于对照组相应结构（P = 0.007）。该发现在重复样本中得到了证实（P = 0.002）。患有综合征2（临床上最严重）的退伍军人在基底神经节和脑干均有NAA/Cr降低的证据；患有综合征1的退伍军人仅在基底神经节有此现象；而患有综合征3的退伍军人仅在脑干有此现象。
患有不同海湾战争综合征的退伍军人在基底神经节和脑干的不同分布区域有神经元损伤的生化证据。
