小脑型多系统萎缩的脑干代谢物：3.0-T 磁共振波谱研究。

Brainstem metabolites in multiple system atrophy of cerebellar type: 3.0-T magnetic resonance spectroscopy study.

机构信息

Center for Integrated Human Brain Science, Brain Research Institute, University of Niigata, Niigata, Japan.

出版信息

Mov Disord. 2011 Jun;26(7):1297-302. doi: 10.1002/mds.23550. Epub 2011 Mar 2.

DOI:10.1002/mds.23550

PMID:21370263

Abstract

BACKGROUND

The aim of this study was to find biomarkers of disease severity in multiple system atrophy of cerebellar type by imaging disease specific regions using proton magnetic resonance spectroscopy on a 3.0 T system.

METHODS

We performed proton magnetic resonance spectroscopy separately in the pons and medulla on 12 multiple system atrophy of cerebellar type patients and 12 age and gender matched control subjects. The metabolite concentrations were estimated from single-voxel proton magnetic resonance spectra measured by point resolved spectroscopy, which were then correlated with clinical severity using Part I, II, and IV of the unified multiple system atrophy rating scale.

RESULTS

Proton magnetic resonance spectroscopy showed that myo-inositol concentrations in both the pons and medulla were significantly higher in multiple system atrophy of cerebellar type patients compared to those of the control subjects (P < 0.05). By contrast, total N-acetylaspartate (the sum of N-acetylaspartate and N-acetylaspartylglutamate) and total choline compounds concentrations in both the pons and medulla were significantly lower in multiple system atrophy of cerebellar type patients compared to control subjects (P < 0.05). Creatine concentration in the pons was significantly higher in multiple system atrophy of cerebellar type patients compared to the control subjects (P < 0.05). Furthermore, a significant correlation was found between the myo-inositol/creatine ratio in the pons and clinical severity, defined by the sum score of unified multiple system atrophy rating scale (I+II+IV) (r = 0.76, P < 0.01).

CONCLUSION

Proton magnetic resonance spectroscopy, in conjunction with a 3.0 T system, can be feasible to detect part of pathological changes in the brainstem, such as gliosis and neuronal cell loss, and the metabolites can be used as biomarkers of clinical severity in multiple system atrophy of cerebellar type patients.

摘要

背景

本研究旨在通过在 3.0T 系统上对质子磁共振波谱成像疾病特异性区域，寻找小脑性多系统萎缩疾病严重程度的生物标志物。

方法

我们分别对 12 例小脑性多系统萎缩患者和 12 名年龄和性别匹配的对照组患者的脑桥和延髓进行质子磁共振波谱分析。使用点分辨波谱法测量单容积质子磁共振波谱，从所得的谱中估计代谢物浓度，然后使用统一多系统萎缩评定量表的第 I、II 和 IV 部分将其与临床严重程度相关联。

结果

质子磁共振波谱显示，小脑性多系统萎缩患者脑桥和延髓的肌醇浓度明显高于对照组（P < 0.05）。相比之下，脑桥和延髓的总 N-乙酰天冬氨酸（N-乙酰天冬氨酸和 N-乙酰天门冬氨酸谷氨酸的总和）和总胆碱化合物浓度明显低于对照组（P < 0.05）。脑桥中的肌酸浓度明显高于对照组（P < 0.05）。此外，脑桥中肌醇/肌酸比值与统一多系统萎缩评定量表总分（I+II+IV）之间存在显著相关性（r = 0.76，P < 0.01）。