Klietz Martin, Bronzlik Paul, Nösel Patrick, Wegner Florian, Dressler Dirk W, Dadak Mete, Maudsley Andrew A, Sheriff Sulaiman, Lanfermann Heinrich, Ding Xiao-Qi
Department of Neurology, Hannover Medical School, Hanover, Germany.
Department of Neuroradiology, Hannover Medical School, Hanover, Germany.
Front Neurol. 2019 Jul 17;10:777. doi: 10.3389/fneur.2019.00777. eCollection 2019.
To estimate alterations in neurometabolic profile of patients with early stage Parkinson's disease (PD) by using a short echo-time whole brain magnetic resonance spectroscopic imaging (wbMRSI) as possible biomarker for early diagnosis and monitoring of PD. 20 PD patients in early stage (H&Y ≤ 2) without evidence of severe other diseases and 20 age and sex matched healthy controls underwent wbMRSI. In each subject brain regional concentrations of metabolites N-acetyl-aspartate (NAA), choline (Cho), total creatine (tCr), glutamine (Gln), glutamate (Glu), and myo-inositol (mIns) were obtained in atlas-defined lobar structures including subcortical basal ganglia structures (the left and right frontal lobes, temporal lobes, parietal lobes, occipital lobes, and the cerebellum) and compared between patients and matched healthy controls. Clinical characteristics of the PD patients were correlated with spectroscopic findings. In comparison to controls the PD patients revealed altered lobar metabolite levels in all brain lobes contralateral to dominantly affected body side, i.e., decreases of temporal NAA, Cho, and tCr, parietal NAA and tCr, and frontal as well as occipital NAA. The frontal NAA correlated negatively with the MDS-UPDRS II ( = 22120.585, = 0.008), MDS-UPDRS IV ( = -0.458, = 0.048) and total MDS-UPDRS scores ( = -0.679, = 0.001). In early PD stages metabolic alterations are evident in all contralateral brain lobes demonstrating that the neurodegenerative process affects not only local areas by dopaminergic denervation, but also the functional network within different brain regions. The wbMRSI-detectable brain metabolic alterations reveal the potential to serve as biomarkers for early PD.
通过使用短回波时间全脑磁共振波谱成像（wbMRSI）来估计早期帕金森病（PD）患者神经代谢谱的改变，将其作为PD早期诊断和监测的潜在生物标志物。20例无其他严重疾病证据的早期PD患者（H&Y≤2）以及20例年龄和性别匹配的健康对照者接受了wbMRSI检查。在每个受试者中，通过图谱定义的脑叶结构（包括皮质下基底神经节结构，即左右额叶、颞叶、顶叶、枕叶和小脑）获取代谢物N-乙酰天门冬氨酸（NAA）、胆碱（Cho）、总肌酸（tCr）、谷氨酰胺（Gln）、谷氨酸（Glu）和肌醇（mIns）的脑区浓度，并在患者和匹配的健康对照者之间进行比较。将PD患者的临床特征与波谱学结果进行关联分析。与对照组相比，PD患者在主要受累身体侧对侧的所有脑叶中均显示出叶代谢物水平的改变，即颞叶NAA、Cho和tCr、顶叶NAA和tCr以及额叶和枕叶NAA降低。额叶NAA与MDS-UPDRS II（r = -22120.585，P = 0.008）、MDS-UPDRS IV（r = -0.458，P = （此处疑似有误，原文应为0.048））和总MDS-UPDRS评分（r = -（此处疑似有误，原文应为0.679），P = 0.001）呈负相关。在PD早期阶段，对侧所有脑叶均出现明显的代谢改变，表明神经退行性过程不仅通过多巴胺能去神经支配影响局部区域，还影响不同脑区之间的功能网络。wbMRSI可检测到的脑代谢改变显示出作为早期PD生物标志物的潜力。
