Griffith H Randall, Okonkwo Ozioma C, O'Brien Timothy, Hollander Jan A den
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
NMR Biomed. 2008 May;21(4):381-7. doi: 10.1002/nbm.1203.
An understanding of the role played by glutamate (Glu) in idiopathic Parkinson's disease (PD) has remained somewhat elusive. Animal models of PD suggest that over-activity of Glu receptors complicates the motor symptoms of PD and that Glu blockade may be a pharmacologic target in PD, whereas patient autopsy studies have proved less convincing for changes in Glu. No previous 1H MRS patient studies have documented changes in glutamate. All but one of these previous studies were performed at 1.5 T. We performed 3 T 1H MRS of the posterior cingulate gyrus in 12 non-demented patients with PD and 12 age-matched, neurologically normal control participants. Glu, N-acetylaspartate (NAA) and choline-containing compounds (Cho) measured in reference to creatine + phosphocreatine (Cr) were determined from single-voxel proton MR spectra measured by PRESS at TE of 80 ms. The results show that the Glu/Cr ratio was reduced in patients with PD compared with controls (t = 2.54; P = 0.019), whereas no differences were observed in NAA/Cr or Cho/Cr ratios. These findings suggest that a reduction in Glu occurs in the cerebral cortex of patients with PD. (1)H MRS at 3 T should be investigated in future studies as a means of tracking the course of metabolic brain changes in association with progression of disease in patients with PD.
对谷氨酸(Glu)在特发性帕金森病(PD)中所起作用的理解一直有些难以捉摸。PD的动物模型表明,Glu受体的过度激活会使PD的运动症状复杂化,并且阻断Glu可能是PD的一个药物靶点,而患者尸检研究在Glu变化方面的说服力较弱。之前尚无1H MRS对患者的研究记录过谷氨酸的变化。这些之前的研究除一项外均在1.5T下进行。我们对12名非痴呆PD患者和12名年龄匹配、神经功能正常的对照参与者的后扣带回进行了3T 1H MRS检查。通过PRESS在80ms的TE下测量的单体素质子MR光谱,测定了以肌酸+磷酸肌酸(Cr)为参照的Glu、N-乙酰天门冬氨酸(NAA)和含胆碱化合物(Cho)。结果显示,与对照组相比,PD患者的Glu/Cr比值降低(t = 2.54;P = 0.019),而NAA/Cr或Cho/Cr比值未观察到差异。这些发现表明,PD患者大脑皮层中Glu含量减少。3T的(1)H MRS应在未来研究中作为追踪PD患者脑代谢变化过程与疾病进展关系的一种手段进行研究。