Cao Hongmei, Shi Jie, Cao Bingqing, Kang Bei, Zhang Ming, Qu Qiumin
Department of Neurology, The First Affiliated Hospital of Medical College of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, China.
Department of Neurology, The Second Affiliated Hospital of Medical College of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi 710004, China.
Neurosci Lett. 2017 Nov 1;660:57-62. doi: 10.1016/j.neulet.2017.08.050. Epub 2017 Aug 24.
The Braak staging of Parkinson's disease (PD) pathology is usually based on the brain autopsy, which has not been confirmed in living patients of PD. In this study, we investigated the metabolites of medulla oblongata, substantia nigra (SN), putamen, and motor cortex by measuring N-acetylaspartate (NAA), choline-containing compounds (Cho) and creatine (Cr) in 22 patients of PD and 15 age-matched healthy controls, using single-voxel H-magnetic resonance spectroscopy (H-MRS). The results showed that NAA/Cr in SN was lower in PD group than that in control group (p=0.006), however, there was no difference for NAA/Cr and Cho/Cr between PD group and control group in other regions. In SN, NAA/Cr was negatively correlated with Unified Parkinson's Disease Rating Scale (UPDRS) (r=-0.743, p=0.002) and Hoehn-Yahr staging (r=-0.714, p=0.003), while Cho/Cr was positively correlated with UPDRS (r=0.850, p<0.001) and Hoehn-Yahr staging (r=0.647, p=0.009). In PD group, the variance of NAA/Cr in SN was significantly larger than that in other regions (p=0.005), but there was no difference for the variance of Cho/Cr among regions of interesting (ROIs) (p=0.267). These results indicate that SN is the most seriously injured region in PD, and the metabolites in SN measured by H-MRS is correlated with the severity of PD. However, the Braak staging of PD pathology is not validated by H-MRS.
帕金森病（PD）病理的Braak分期通常基于脑尸检，这在PD的活体患者中尚未得到证实。在本研究中，我们通过使用单体素氢磁共振波谱（H-MRS）测量22例PD患者和15例年龄匹配的健康对照者延髓、黑质（SN）、壳核和运动皮层的代谢物，包括N-乙酰天门冬氨酸（NAA）、含胆碱化合物（Cho）和肌酸（Cr）。结果显示，PD组SN中的NAA/Cr低于对照组（p = 0.006），然而，PD组和对照组在其他区域的NAA/Cr和Cho/Cr没有差异。在SN中，NAA/Cr与统一帕金森病评定量表（UPDRS）呈负相关（r = -0.743，p = 0.002）和Hoehn-Yahr分期呈负相关（r = -0.714，p = 0.003），而Cho/Cr与UPDRS呈正相关（r = 0.850，p < 0.001）和Hoehn-Yahr分期呈正相关（r = 0.647，p = 0.009）。在PD组中，SN中NAA/Cr的方差显著大于其他区域（p = 0.005），但感兴趣区域（ROIs）之间Cho/Cr的方差没有差异（p = 0.267）。这些结果表明，SN是PD中损伤最严重的区域，通过H-MRS测量的SN中的代谢物与PD的严重程度相关。然而，PD病理的Braak分期未通过H-MRS得到验证。
