Key Words: Parkinson's disease, Magnetic resonance spectroscopy (MRS) 대한신경과학회지 21 권 6 호
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1 Jong-Ki Kim,.D., Byeong-Chae Kim,.D., Kee-Ra Lee,.D., in-kyung Song,.D., an-seok Park,.D., yeong-kyu Kim,.D., Ki-Hyun Cho,.D., Jeong-Jin Seo,.D. Background: Parkinson's disease is a progressive, common neuro-degenerative disorder of the extrapyramidal system leading to specific motor symptoms, but there is no specific early diagnostic tool. This study was aimed to investigate the change of cerebral metabolites in patients with parkinson's disease by H magnetic resonance spectroscopy (RS). ethods: Eighteen patients with idiopathic unilateral symptomatic parkinson's disease underwent RS study to compare metabolites of basal ganglia and thalamus, in ipsilateral and contralateral to the clinically affected side. Results: In patients with unilateral symptomatic parkinson's disease, N-acetyl aspartate (NAA)/Creatine (Cr) ratio was significantly lower in contralateral side to the clinically affected side than in ipsilateral side (p=0.02). Other cerebral metabolites (Cho, mi, - Glx, -Glx, lactate, lipid) were showed no significant difference in patients with parkinson's disease. Conclusions: The comparison and quantification of cerebral metabolites by using RS may be helpful to diagnosis and investigation of parkinson's disease. J Korean Neurol Assoc 2(6): , 200 Key Words: Parkinson's disease, agnetic resonance spectroscopy (RS) 서론 대한신경과학회지 2 권 6 호
2 대상과방법 igure.. Region of interest (ROI) in T weighted image. ROIs are 8 cm sized areas including thalamus, genu and posterior limb of internal capsule, and small part of putamen in both hemispheres. 결과 2 권 6 호대한신경과학회지
3 igure 2. agnetic resonance spectrum (RS). By using RS, we obtains cerebral metabolites from the left cerebral hemisphere (A) and from the right hemisphere (B) in patient with left symptomatic Parkinson's disease. NAA; N-acetyl aspartate, Cr; creatine, Cho; choline, mi; myo-inositol, a-glx; a-glutamate & glutamine, b-glx; b and r-glutamate & glutamine. Table. The clinical characteristics of patients with Parkinson's disease Case No Sex Age (yr) Duration of disease (yr) ean±sd 65.± ±.4 No; numbers, yr; year Affected Side igure. Comparison of NAA/Cr ratio. In patients with unilateral symptomatic Parkinson's disease, NAA/Cr ratio is significantly lower in contralateral to the clinically affected side than in ipsilateral side. 고찰 대한신경과학회지 2 권 6 호
4 Table 2. Results from magnetic resonance spectroscopy of patients with unilateral symptomatic Parkinson's disease in contralateral and ipsilateral to the clinically affected side, and p-value comparing between two sides. Case No. NAA/Cr Cho/Cr ml/cr α-glx/cr β-glx/cr Lac/Cr Lip/Cr C Ip C Ip C Ip C Ip C Ip C Ip C Ip ean SD C Ip p Value NAA; N-acetyl aspartate, Cr; Creatine, Cho; Choline, mi; myo-inositol, α-glx; α-glutamate & glutamine, β-glx; b-and r-glutamine, Lac; Lactate, Lip; Lipid, C; Contralateral, Ip; Ipsilateral, SD; Standard deviation 권 6 호대한신경과학회지
5 대한신경과학회지 2 권 6 호
6 . orno LS. Neuropathology of parkinson's disease. J Neuropathol Exp Neurol 996;55: offett JR, Namboodiri A, Cangro CB, Neale JH. Immunohistochemical localization of N-acetyl aspartate in rat brain. Neuroreport 99;2:-4.. Simmons L, rondoza CG, Coyle JT. Immunocytochemical localization of N-acetyl aspartate with monoclonal antibodies. Neuroscience 99;45: Pioro EP. R spectroscopy in amyotrophic lateral sclerosis/ motor neuron disease. J Neurological Sciences 997;52: Calne DB, Snow BJ, Lee C. Criteria for diagnosing parkinson's disease. Ann Neurol 992;2: Rajput AH, Rozdilsky B, Rajput A. Accuracy of clinical diagnosis in parkinsonism - a prospective study. Can J Neurol Sci 99;8: Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic parkinson's disease: a clinicopathological study of 00 cases. J Neurol Neurosurg Psychiatry 992;55: Choe BY, Suh TS, Bahk YW, Shinn KS. In vivo H R Spectroscopy of human brain in six normal volunteers. J Korean Radiol Soc 99;29: Choi CG, Kim ST, Choi SI, Lee HK, Suh DC, Lim TW, et al. Localized single-voxel spin-echo proton R Spectroscopy of normal hippocampal area at.5t: optimal voxel volume and reproducibility of metabolite ratios. J Korean Radiol Soc 997;7: Erik P. Pioro. R spectroscopy in amyotrophic lateral sclerosis/motor neuron disease. J Neurological Sciences 997;52: Hu T, Taylor-Robinson SD, Chaudhuri KR, Bell JD, orris RG, Clough C, et al. Evidence for cortical dysfunction in clinically non-demented patients with parkinson's disease: a proton R spectroscopy study. J Neurol Neurosurg Psychiatry 999;67: irbank J, Harrison R, O'Brien JT. A comprehensive review of proton magnetic resonance spectroscopy studies in dementia and Parkinson's disease. Dement Geriatr Cogn Disord 2002;4(2): Choe BY, Park JW, Lee KS, Son BC, Kim C, Kim BS, et al. Neuronal laterality in parkinson's disease with unilateral symptom by in vivo H magnetic resonance spectroscopy. Investigative Radiology 998;: ederico, Simone IL, Lucivero V, De ari, Giannini P, Iliceto G, et al. Proton magnetic resonance spectroscopy in parkinson's disease and progresive supranuclear palsy. J Neurol Neurosurg Psychiatry 997;62: ederico, Simone IL, Lucivero V, Iliceto G, De ari, Giannini P, et al. Proton magnetic resonance spectroscopy in parkinson's disease and atypical parkinsonian disorders. ov Disord 997;2: Roser W, Bubl R, Buergin D, Seelig J, Radue EW, Rost B. etabolic changes in the brain of patients with anorexia and bulimia nervosa as detected by proton magnetic resonance spectroscopy. International Journal of Eating Disorders 999; 26: Pu Y, Li Q, Zeng C, Gao J, Qi J, Luo DX, et al. Increased detectability of alpha brain glutamate/glutamine in neonatal hypoxic-ischemic encephalopathy. Am J Neuroradiol 2000;2: Jayasundar R, Singh VP, Raghunathan P, Jain K, Banerji AK. Inflammatory granulomas: evaluation with proton RS. NR in Biomed 999;2: 권 6 호대한신경과학회지
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