Qu Biao, Li Xiaoyuan, Xiao Min, Chen Runhan, Tan Hejuan, Sun Hongwei, Li Rushuai, Xu Jingjing, Dong Jiyang, Zheng Gaofeng, Ai Shuyue, Qu Xiaobo
Pen-Tung Sah Institute of Micro-Nano Science and Technology, Xiamen University, Xiamen, China.
Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Quant Imaging Med Surg. 2023 Oct 1;13(10):6646-6655. doi: 10.21037/qims-23-231. Epub 2023 Aug 22.
The diagnosis of Parkinson's disease (PD) is challenging because the clinical symptoms overlap with other neurodegenerative diseases. The discovery of reliable biomarkers is highly expected to facilitate clinical diagnosis. Through the analysis of the H magnetic resonance spectroscopy (H-MRS) in the putamen, the purpose of the study was to discuss the possibility of the difference in metabolite concentrations between the left and right putamen as biomarkers for patients with severe PD.
We collected H-MRS of unilateral or bilateral putamen from 41 patients and used the independent sample -test and paired -test to analyze 4 metabolite concentrations, including choline (Cho), total N-acetyl aspartate (tNAA), total creatine (tCr), and combined glutamate and glutamine; Bonferroni correction was used to correct P values for multiple comparisons. We designed 4 controlled experiments as follows: (I) PD patients versus healthy controls (HCs) in the left putamen; (II) PD patients versus HCs in the right putamen; (III) the left putamen versus the right putamen for PD patients; and (IV) the left putamen versus the right putamen for HCs.
No statistically significant differences (P>0.05) were detected among 4 metabolites in the ipsilateral and bilateral putamen for the PD and HCs groups, except for tCr in the left putamen (PD 6.426±0.557, HCs 6.026±0.460, P=0.046) for ipsilateral comparisons.
In the bilateral putamen of severe PD patients, there was no statistically significant difference in the 4 metabolites. The difference (P<0.05) in tCr in the left putamen might be a potential biomarker to distinguish HCs from severe patients in clinic. This might provide a reference for the clinical diagnosis and acquisition strategy of 1H-MRS in severe PD.
帕金森病（PD）的诊断具有挑战性，因为其临床症状与其他神经退行性疾病存在重叠。人们高度期望发现可靠的生物标志物以促进临床诊断。通过对壳核的氢磁共振波谱（H-MRS）分析，本研究旨在探讨重度PD患者左右壳核代谢物浓度差异作为生物标志物的可能性。
我们收集了41例患者单侧或双侧壳核的H-MRS，并使用独立样本t检验和配对t检验分析4种代谢物浓度，包括胆碱（Cho）、总N-乙酰天门冬氨酸（tNAA）、总肌酸（tCr）以及谷氨酸和谷氨酰胺的总和；采用Bonferroni校正对多重比较的P值进行校正。我们设计了如下4个对照实验：（I）左侧壳核的PD患者与健康对照（HCs）；（II）右侧壳核的PD患者与HCs；（III）PD患者的左侧壳核与右侧壳核；（IV）HCs的左侧壳核与右侧壳核。
PD组和HCs组同侧及双侧壳核的4种代谢物中，除同侧比较时左侧壳核的tCr外（PD为6.426±0.557，HCs为6.026±0.460，P = 0.046），未检测到统计学显著差异（P>0.05）。
在重度PD患者的双侧壳核中，4种代谢物无统计学显著差异。左侧壳核中tCr的差异（P<0.05）可能是临床上区分HCs与重度患者的潜在生物标志物。这可能为重度PD的临床诊断及1H-MRS采集策略提供参考。
