Ciurleo Rosella, Bonanno Lilla, Di Lorenzo Giuseppe, Bramanti Placido, Marino Silvia
IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy.
IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy; Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy.
Neurosci Lett. 2015 Jul 10;599:55-60. doi: 10.1016/j.neulet.2015.05.044. Epub 2015 May 22.
The aim of this study was to assess metabolic changes in the motor cortex in de novo Parkinson's disease (PD) patients before and after therapy with ropinirole. Twenty de novo drug-naïve PD patients and 15 healthy controls underwent conventional magnetic resonance imaging and proton magnetic resonance spectroscopy imaging ((1)H-MRSI). The resonance intensities of N-acetylaspartate (NAA) and choline (Cho) were normalized for the resonance intensities of creatine (Cr). At baseline, lower NAA/Cr and NAA/Cho ratios and higher Cho/Cr ratios were found in the motor cortex of PD patients compared with controls (p<0.001). Ten months after ropinirole treatment, PD patients showed a significant clinical improvement in the UPDRS motor sub-scores (p<0.001) and an increase of NAA/Cr and NAA/Cho ratios (p<0.006 and p=0.01, respectively). A highly significant correlation between NAA/Cr and NAA/Cho ratios and UPDRS motor sub-scores was observed (r=-0.981 and r=-0.983, respectively). We could argue that the ropinirole efficacy to improve the motor performances is the result of partial restoration of neuronal functions, due to the increase of NAA in motor cortex.
本研究的目的是评估初发帕金森病（PD）患者在接受罗匹尼罗治疗前后运动皮层的代谢变化。20例初发未用药的PD患者和15名健康对照者接受了传统磁共振成像和质子磁共振波谱成像（（1）H-MRSI）。将N-乙酰天门冬氨酸（NAA）和胆碱（Cho）的共振强度按肌酸（Cr）的共振强度进行标准化。在基线时，与对照组相比，PD患者运动皮层的NAA/Cr和NAA/Cho比值较低，Cho/Cr比值较高（p<0.001）。罗匹尼罗治疗10个月后，PD患者的统一帕金森病评定量表（UPDRS）运动分项评分有显著临床改善（p<0.001），NAA/Cr和NAA/Cho比值增加（分别为p<0.006和p=0.01）。观察到NAA/Cr和NAA/Cho比值与UPDRS运动分项评分之间存在高度显著的相关性（分别为r=-0.981和r=-0.983）。我们可以认为，罗匹尼罗改善运动表现的疗效是由于运动皮层中NAA增加，神经元功能部分恢复的结果。
