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目的:应用磁共振波谱(1H-MRS)测定帕金森病(PD)患者不同脑区代谢产物的变化,探讨其与PD运动症状的关系,在活体上验证Braak病理分级。方法:临床确诊的PD患者为PD组;与PD组年龄、性别、文化程度相匹配的为正常对照组,两组各10例,应用Hoehn-Yahr分级及UPDRS评价PD运动功能,1H-MRS测定延髓、受累较重侧中脑、壳核及皮质运动区感兴趣区的代谢产物含量,分析代谢产物含量与PD运动评分的关系。结果:PD组中脑及壳核NAA/Cr比值明显低于正常对照组(P<0.05);中脑Cho/Cr比值明显高于正常对照组(P<0.05)。其余部位的NAA/Cr和Cho/Cr比值,PD组与正常对照组差异无统计学意义(P>0.05)。NAA/Cr和Cho/Cr比值与PD患者Hoehn-Yahr分级、UPDRS总分、UPDRS运动评分、症状严重侧肢体运动评分均无相关性(P>0.05);PD组延髓、中脑、壳核及皮质运动区之间NAA/Cr相对值、Cho/Cr相对值均差异无统计学意义(P>0.05)。结论:1H-MRS测定的PD脑代谢产物含量与PD病情无关,不能反映Braak病理分级。
OBJECTIVE: To determine the changes of metabolites in different brain regions of patients with Parkinson’s disease (PD) by magnetic resonance spectroscopy (1H-MRS), and to explore the relationship between the metabolic syndrome and PD motor symptoms. Methods: The PD patients were diagnosed as PD group. Compared with PD group, the age, sex, and education level of PD group were normal control group and 10 cases in each group. Hoehn-Yahr classification and UPDRS were used to evaluate PD motor function. 1H- Medulla oblongata, involved the heaviest lateral mesencephalon, putamen and cortical areas of interest metabolites content, analysis of the relationship between metabolites and PD motor score. Results: The ratio of NAA / Cr in midbrain and putamen in PD group was significantly lower than that in normal control group (P <0.05). Cho / Cr ratio in midbrain was significantly higher than that in normal control group (P <0.05). The ratios of NAA / Cr and Cho / Cr in other sites showed no significant difference between PD group and normal control group (P> 0.05). NAA / Cr and Cho / Cr ratio had no correlation with Hoehn-Yahr grade, UPDRS score, UPDRS movement score and severe symptom of lateral limb movement score in PD patients (P> 0.05); PD, medulla oblongata, There was no significant difference in relative values of NAA / Cr and Cho / Cr between cortical areas (P> 0.05). Conclusion: The content of PD brain metabolites detected by 1H-MRS has nothing to do with the disease of PD, and can not reflect the pathological grade of Braak.