Brain proton magnetic resonance spectroscopy in patients with Parkinson’s disease

Ali Shoeibi; Mahdieh Verdipour; Alireza Hoseini; Mehdi Moshfegh; Nahid Olfati; Parvaneh Layegh; Maliheh Dadgar-Moghadam; Mohammad Taghi  Farzadfard; Fariborz Rezaeitalab; Nahid Borji

doi:10.18502/cjn.v21i3.11108

Ali Shoeibi Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Mahdieh Verdipour Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Alireza Hoseini Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Mehdi Moshfegh Department of Neurology, Atieh Hospital, Tehran, Iran
Nahid Olfati Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Parvaneh Layegh Department of Radiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Maliheh Dadgar-Moghadam Department of Community and Family Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Mohammad Taghi Farzadfard Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Fariborz Rezaeitalab Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Nahid Borji Department of Radiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

DOI: https://doi.org/10.18502/cjn.v21i3.11108

Keywords: Parkinson Disease; Magnetic Resonance Spectroscopy; Basal Ganglia; Motor Cortex

Abstract

Background: The accuracy of current laboratory and imaging studies for diagnosis and monitoring of Parkinson’s disease (PD) severity is low and diagnosis is mainly dependent on clinical examination. Proton magnetic resonance spectroscopy (MRS) is a non-invasive technique that can assess the chemical profile of the brain. In this study, we evaluated the utility of proton MRS in diagnosis of PD and determination of its severity.

Methods: Patients with PD and healthy age-matched controls were studied using proton MRS. The level of N-acetylaspartate (NAA), total creatine (Cr), and total choline (Cho), and their ratios were calculated in substantia nigra (SN), putamen (Pu), and motor cortex. PD severity was assessed by the Unified Parkinson’s Disease Rating Scale (UPDRS) and the Hoehn and Yahr scale.

Results: Compared to 25 healthy controls (18 men, age: 59.00 ± 8.39 years), our 30 patients with PD (24 men, age: 63.80 ± 12.00 years, 29 under treatment) showed no significant difference in the metabolite ratios in SN, Pu, and motor cortex. Nigral level of NAA/Cr was significantly correlated with total UPDRS score in patients with PD (r = -0.35, P = 0.08). Moreover, patients with PD with Hoehn and Yahr scale score ≥ 2 had a lower NAA/Cr level in SN compared to patients with a lower stage.

Conclusion: This study shows that 1.5 tesla proton MRS is unable to detect metabolite abnormalities in patients with PD who are under treatment. However, the NAA/Cr ratio in the SN might be a useful imaging biomarker for evaluation of disease severity in these patients.