Tedeschi G, Litvan I, Bonavita S, Bertolino A, Lundbom N, Patronas N J, Hallett M
Neuroimaging Branch, NINDS, National Institutes of Health, Bethesda, MD, USA.
Brain. 1997 Sep;120 ( Pt 9):1541-52. doi: 10.1093/brain/120.9.1541.
We used proton magnetic resonance spectroscopic imaging (1H-MRSI) to assess the in vivo cortical and subcortical neuronal involvement in progressive supranuclear palsy, Parkinson's disease and corticobasal degeneration. This technique permitted the simultaneous measurement of compounds containing N-acetylaspartate (NA), choline (Cho), creatine-phosphocreatine (Cre) and lactate, from four 15-mm slices divided into 0.84-ml single-volume elements. The study included 12 patients with progressive supranuclear palsy, 10 with Parkinson's disease, nine with corticobasal degeneration and 11 age-matched normal control subjects. Regions of interest were selected from the brainstem, caudate, thalamus, lentiform nucleus, centrum semiovale, and from frontal, parietal, precentral, temporal and occipital cortices. Progressive supranuclear palsy patients, compared with control subjects, had significantly reduced NA/Cre in the brainstem, centrum semiovale, frontal and precentral cortex, and significantly reduced NA/Cho in the lentiform nucleus. Corticobasal degeneration patients, compared with control subjects, had significantly reduced NA/Cre in the centrum semiovale, and significantly reduced NA/Cho in the lentiform nucleus and parietal cortex. There were no significant differences between Parkinson's disease patients and control subjects, or between patients groups in any individual region of interest. In the parietal cortex of corticobasal degeneration patients, NA/Cho was significantly reduced contralateral to the most affected side. There were statistically significant group differences in the regional pattern of NA/Cre and NA/Cho reduction, comparing normal control subjects with all patient groups, Parkinson's disease with corticobasal degeneration, and Parkinson's disease with progressive supranuclear palsy. Although the occurrence of significant groups differences does not imply that it is possible to differentiate between individual patients using 1H-MRSI in progressive supranuclear palsy and corticobasal degeneration, detection of specific cortical and subcortical patterns of neuronal involvement is possible with this technique. We suggest that this regional pattern of neuronal involvement found in progressive supranuclear palsy and corticobasal degeneration may help in the diagnostic evaluation of affected individuals.
我们使用质子磁共振波谱成像（1H-MRSI）来评估进行性核上性麻痹、帕金森病和皮质基底节变性中体内皮质和皮质下神经元的受累情况。该技术能够同时测量来自四个15毫米切片（分为0.84毫升单体积元素）中含N-乙酰天门冬氨酸（NA）、胆碱（Cho）、肌酸-磷酸肌酸（Cre）和乳酸的化合物。该研究纳入了12例进行性核上性麻痹患者、10例帕金森病患者、9例皮质基底节变性患者以及11例年龄匹配的正常对照者。感兴趣区域选自在脑干、尾状核、丘脑、豆状核、半卵圆中心以及额叶、顶叶、中央前回、颞叶和枕叶皮质。与对照者相比，进行性核上性麻痹患者在脑干、半卵圆中心、额叶和中央前回皮质的NA/Cre显著降低，在豆状核的NA/Cho显著降低。与对照者相比，皮质基底节变性患者在半卵圆中心的NA/Cre显著降低，在豆状核和顶叶皮质的NA/Cho显著降低。帕金森病患者与对照者之间，或各患者组在任何单个感兴趣区域之间均无显著差异。在皮质基底节变性患者的顶叶皮质中，NA/Cho在最受累侧的对侧显著降低。将正常对照者与所有患者组、帕金森病与皮质基底节变性、帕金森病与进行性核上性麻痹进行比较时，NA/Cre和NA/Cho降低的区域模式存在统计学显著的组间差异。虽然显著的组间差异的出现并不意味着使用1H-MRSI能够在进行性核上性麻痹和皮质基底节变性中区分个体患者，但通过该技术可以检测到特定的皮质和皮质下神经元受累模式。我们认为，在进行性核上性麻痹和皮质基底节变性中发现的这种神经元受累区域模式可能有助于对受影响个体的诊断评估。
