儿童抽动秽语综合征患者双侧壳核容积与代谢改变的MR研究

目的:采用MR容积分析及MRS对比研究儿童抽动-秽语综合征(TS)患者双侧壳核的容积与代谢改变及其相关性,探讨TS患者的病理生理机制.方法:搜集18例儿童TS患者(TS组)及18例年龄性别相匹配的健康志愿者(对照组),用容积分析软件对TS患者及正常对照组双侧壳核进行容积测量,采用单体素氢质子MRS对TS患者及对照组壳核进行数据采集和分析,根据峰下面积大小分别计算NAA/Cr、Cho/Cr值.将测得的NAA/Cr值与壳核的容积进行相关性分析.结果:TS组(左侧壳核:NAA/Cr=1.17±0.15,Cho/Cr=0.81±0.13;右侧壳核:NAA/Cr=1.09±0.09,Cho/Cr=0.78±0.17)与对照组(左侧壳核:NAA/Cr=1.43±0.03,Cho/Cr=0.70±0.12;右侧壳核:NAA/Cr=1.39±0.06,Cho/Cr=0.75±0.10)相比,TS患者双侧壳核NAA/Cr明显减低,差异具有统计学意义(P均＜0.05),两组间两侧Cho/Cr差异均无统计学意义(P均＞0.05).TS组和对照组左侧与右侧NAA/Cr、Cho/Cr差异均无统计学意义(P＞0.05).TS组与对照组双侧壳核容积差异无统计学意义(左:t=0.536,P＞0.05;右:t=1.758,P＞0.05).TS组和对照组左侧与右侧壳核容积差异均无统计学意义(TS组:t=1.501,P＞0.05;对照组:t=0.481,P＞0.05).TS组和对照组双侧壳核NAA/Cr值与容积大小均无相关性(P＞0.05).结论:壳核可能参与了儿童TS患者的病理生理过程,MRS比容积测量对TS患者的壳核的改变更敏感.     

脑质子磁共振波谱在早期帕金森病诊断中的价值

目的　探讨质子磁共振波谱 ( 1H -MRS)在早期帕金森病 (Parkinson’sdisease ,PD)诊断中的临床应用价值。方法　对 10例偏侧PD患者 (Hoehn -YahrⅠ级 )和 10例年龄匹配正常对照者双侧基底节区进行 1H -MRS检测 ,对比分析PD患者患侧肢体对侧和同侧以及正常对照者的基底节区N -乙酰基天门冬氨酸 (NAA) /肌酸复合物 (Cr)和胆碱复合物 (Cho) /Cr比值的变化。结果　PD组患者患侧肢体对侧的基底节区NAA/Cr比值显著低于同侧和正常对照组 (P <0 .0 5 ) ,Cho/Cr比值显著高于同侧和正常对照组 (P<0 .0 5 ) ;PD组患者患侧肢体同侧的基底节区NAA/Cr和Cho/Cr比值与正常对照组比较无显著差异 (P >0 .0 5 )。结论　1H -MRS是可以为具有单侧症状的PD患者基底节区的神经细胞病理学改变提供有价值的信息的一种无创技术     

单侧颞叶癫痫病人双侧基底节区多体素MRS研究

目的 采用多体素MRS探讨单侧颞叶癫痫（TLE）病人双侧基底节区代谢物改变。方法 选取根据临床发作症状和脑电图综合诊断的左侧TLE病人10例,右侧TLE病人10例,正常志愿者10例纳入研究。所有TLE病人均进行利物浦痫性发作严重程度量表2.0（LSSS 2.0）评估,采用Simens 3.0 T超导MR设备进行多体素1H-MRS数据采集,对称性测量双侧尾状核头、豆状核和丘脑的N-乙酰天门冬氨酸（NAA）、乙酰胆碱（Cho）、肌酸（Cr）含量,计算各兴趣区NAA/Cr和Cho/Cr比值并进行统计学分析,将代谢物比值与LSSS 2.0评分进行Pearson相关分析。结果 左侧TLE组双侧丘脑NAA/Cr比值分别为1.92±0.15（左）和2.02±0.26（右）,右侧TLE组双侧丘脑NAA/Cr比值分别为2.19±0.16（左）和1.79±0.16（右）,均明显低于对照组[2.37±0.14（左）和2.36±0.10（右）,P＜0.05]。右侧TLE组,其致痫灶同侧丘脑的NAA/Cr比值较对侧丘脑要低（P＜0.05）。TLE组致痫灶同侧丘脑NAA/Cr比值与LSSS 2.0评分呈负相关（左侧 r=-0.667;右侧r=-0.643,均P＜0.05）。结论 单侧TLE病人存在双侧丘脑神经元丢失和/或功能障碍,且致痫灶同侧丘脑NAA/Cr比值与LSSS 2.0评分可以一致性反映近期痫性发作严重程度。     

单侧颞叶癫病人双侧基底节区多体素MRS研究

目的采用多体素MRS探讨单侧颞叶癫(TLE)病人双侧基底节区代谢物改变。方法选取根据临床发作症状和脑电图综合诊断的左侧TLE病人10例,右侧TLE病人10例,正常志愿者10例纳入研究。所有TLE病人均进行利物浦性发作严重程度量表2.0(LSSS 2.0)评估,采用Simens 3.0 T超导MR设备进行多体素1H-MRS数据采集,对称性测量双侧尾状核头、豆状核和丘脑的N-乙酰天门冬氨酸(NAA)、乙酰胆碱(Cho)、肌酸(Cr)含量,计算各兴趣区NAA/Cr和Cho/Cr比值并进行统计学分析,将代谢物比值与LSSS 2.0评分进行Pearson相关分析。结果左侧TLE组双侧丘脑NAA/Cr比值分别为1.92±0.15(左)和2.02±0.26(右),右侧TLE组双侧丘脑NAA/Cr比值分别为2.19±0.16(左)和1.79±0.16(右),均明显低于对照组[2.37±0.14(左)和2.36±0.10(右),P0.05]。右侧TLE组,其致灶同侧丘脑的NAA/Cr比值较对侧丘脑要低(P0.05)。TLE组致灶同侧丘脑NAA/Cr比值与LSSS 2.0评分呈负相关(左侧r=-0.667;右侧r=-0.643,均P0.05)。结论单侧TLE病人存在双侧丘脑神经元丢失和/或功能障碍,且致灶同侧丘脑NAA/Cr比值与LSSS 2.0评分可以一致性反映近期性发作严重程度。     

弥散张量成像对早期帕金森病的研究价值

目的:探讨弥散张量成像(DTI)对早期原发性单侧症状帕金森病(PD)的诊断价值,为临床诊断及疾病分级提供参考及依据.方法:26例未经治疗的早期原发性单侧症状帕金森病患者为PD组,20例健康正常人为对照组,对两组均进行常规磁共振(MRI)及DTI检查,检查前对PD组均进行UPDRS评分及Hoehn&Yahr分期,DTI测量双侧黑质、壳核、尾状核头部及丘脑的各向异性分数(FA值)及表观弥散系数(ADC值).结果:PD组症状对侧黑质的FA值较同侧及对照组双侧均值显著减低(t=2.987,P=0.004;t=3.072,P=0.003),其余感兴趣区FA值及所有感兴趣区ADC值组内及组间均无明显差异;症状对侧黑质FA值与UPDRS评分无明显相关性.结论:单侧症状PD患者症状对侧黑质早期就存在FA值减低,DTI技术可作为早期帕金森病诊断的一项无创性检查方法,但对判断疾病的严重程度无帮助.     

外伤性脑损伤脑桥快速波谱成像研究

目的探讨颅脑外伤(TBI)所致脑桥代谢物变化规律及其与预后的关系。方法对34例TBI患者行快速波谱成像(TSI),获得NAA/Cr、Cho/Cr、Cho/NAA值,并与16例正常志愿者(对照组)进行对比。将TBI组根据格拉斯哥预后评分分为预后良好、中等、差3组,比较不同组间代谢物水平差别。结果 TBI组34例脑桥NAA/Cr、Cho/Cr、Cho/NAA均值分别为2.51±0.73、2.56±0.67、1.05±0.29;对照组16例NAA/Cr、Cho/Cr、Cho/NAA均值分别为2.70±0.37、1.92±0.09、0.72±0.08。两组间NAA/Cr均值差异无统计学意义(P=0.235),两组间Cho/Cr、Cho/NAA均值差异有显著统计学意义(P值均=0.000)。NAA/Cr在预后差组(2.15±0.56)与预后中等组(2.73±0.58)之间、预后差与预后良好组(2.98±0.90)间差异有统计学意义(P值分别为0.036、0.007)。Cho/Cr 3组之间差异无统计学意义。Cho/NAA在预后差组(1.22±0.31)与预后良好组(0.80±0.15)之间差异有统计学意义(P=0.001)。结论 TSI适合TBI脑桥MRS检测,TBI患者脑桥Cho/Cr和Cho/NAA较正常人升高,而NAA/Cr和Cho/NAA比值对TBI预后判断较有意义。     

帕金森病中脑黑质3D多体素~1H-MRS研究

目的探讨1H-MRS检测帕金森病(Parkinson's disease,PD)黑质神经元代谢产物变化的意义。方法 PD患者30例,正常对照组20例。采用3.0T MRI对PD患者及正常对照者黑质进行3D多体素1H-MRS检测,获得代谢物间相对比值,NAA/Cr、NAA/Cho、NAA/(Cho+Cr)。然后,对PD组与正常对照组黑质代谢产物进行比较;对非对称PD患者两侧黑质代谢产物进行比较;对不同病情程度的PD的黑质代谢产物进行比较。结果 1)PD组与对照组黑质NAA/Cr、NAA/Cho、NAA/(Cho+Cr)相对比差异有显著性(P0.05);2)PD组患肢对侧与患肢同侧黑质NAA/Cr、NAA/Cho、NAA/(Cho+Cr)相对比差异有显著性(P0.05);3)H-Y分级较轻组与较重组组间黑质NAA/Cr、NAA/Cho、NAA/(Cho+Cr)相对比差异有显著性(P0.05)。结论 PD患者黑质代谢产物有变化,非对称性PD患者两侧黑质代谢产物含量不同,病情较轻组与较重组黑质代谢产物有差异,1H-MRS检测黑质代谢产物含量对PD早期诊断具有重要作用。     

原发性单侧症状帕金森病黑质的DTI研究

目的:研究帕金森病(PD)黑质的DTI 改变状况,探讨PD早期诊断的线索.方法:以原发单侧症状PD患者10例为PD组,年龄和性别相匹配的健康志愿者10名为对照组.两组分别予以磁共振DTI脑检查,测量计算双侧黑质区域的ADC 值和FA 值,并将PD组和对照组进行对比分析.结果:原发单侧症状PD组患者症状对侧的黑质FA值较同侧和健康对照组FA值明显下降(分别为0.254±0.083,0.314±0.022,0.409±0.043;t=-2.424,P=0.038<0.05和t=5.112,P=0.001<0.05).对照组双侧黑质FA值之间差异无显著意义(分别为0.406±0.046,0.419±0.030;t=-1.1871,P=0.301>0.05).PD组症状的同侧黑质FA值与对照组之间差异也有显著意义(分别为0.409±0.043,0.314±0.022;t=6.214,P=0.002<0.05).PD组症状对侧和同侧黑质部位ADC值与对照组之间差异无显著意义(分别为t=0.140,P=0.893>0.05和t=0.334,P=0.748>0.05).结论:单侧症状PD患者的对侧黑质早期就可能存在神经元的缺失或轴突功能受损,提示黑质部位FA值分析可作为PD早期或亚临床诊断的线索之一.     

首发抑郁症患者脑兴趣区的磁共振质子波谱分析

目的 探讨首发抑郁症患者额叶白质、海马及杏仁核的脑代谢有无异常.方法 利用质子磁共振波谱分析(1HMRS)技术检测20例首发抑郁症患者和20名健康志愿者的额叶白质、海马及杏仁核的多个代谢指标,包括N-乙酰天门冬氨酸盐(NAA)、胆碱复合物(Cho)、肌醇(MI)、肌酸(Cr).结果 与对照组相比,抑郁症组患者双侧额叶白质的Cho/Cr值上升(左:t=2.62,P=0.04;右:t=2.68,P=0.05),MI/Cr值下降(左:t=2.9,P=0.03;右:t=3.1,P=0.02);抑郁症组患者双侧海马的NAA/Cr、Cho/Cr均低于对照组(NAA/Cr:左t=3.06,P=0.004;右t=3.54,P=0.001.Cho/Cr:左t=2.94,P=0.006;右t=4.02,P=0.001);抑郁症组患者双侧杏仁核的Cho/Cr、NAA/Cr比值均明显低于对照组(Cho/Cr:左t=5.035,P=0.007;右t=8.681,P=0.001,NAA/Cr:左t=9.899,P=0.001;右t=7.227,P=0.002).结论 额叶白质、海马及杏仁核的代谢异常可能构成首发抑郁症的神经生物学基础.     

慢性酒精依赖患者海马体积的MRI及1H-MRS测量结果

目的 观察慢性酒精依赖(CAD)患者双侧海马体积变化及1H-MRS表现,为CAD患者的临床诊断起量化指导作用.方法 选取临床确诊的16例CAD患者(CAD组)和18名正常志愿者(对照组)分别进行MR常规扫描、三维快速扰相位梯度回波(3D-FSPGR)扫描以及海马1H-MRS扫描,分别测量两组受试者海马体积,并对CAD组及对照组的双侧海马标准化体积进行比较;测量两组双侧海马头部的N-乙酰天冬氨酸(NAA)、胆碱(Cho)、肌醇(ml)以及肌酸(Cr),对Cho/Cr、Cho/NAA、NAA/Cr及mI/Cr比值进行比较.两组间海马体积及双侧海马头部1H-MRS监测值的比较采用t检验.结果 CAD组左、右侧海马体积分别为1.881±0.292、2.139±0.328,对照组分别为2.106±0.245、2.267-±0.271,CAD组及对照组内左、右侧海马体积差异无统计学意义(t值分别为0.232、0.147,P值均＞0.05);两组间左、右侧海马体积差异也无统计学意义(t值分别为0.424、0.131,P值均＞0.05).CAD组的右侧海马头部Cho/Cr、NAA/Cr分别为1.225±0.210、1.145±0.034,对照组分别为1.429±0.286、1. 612±0.444,两组间差异有统计学意义(t值分别为0.321、0.408,P值均＜0.05).两组间海马头部右侧Cho/NAA、mI/Cr及左侧Cho/Cr、Cho/NAA、NAA/Cr及mI/Cr差异均无统计学意义.结论 CAD患者尚未出现脑组织形态学改变之前,1H-MRS的表现具有为临床早期诊断提供客观量化依据的潜能.     

高场强~1H-MRS对帕金森病大鼠模型的应用价值探讨

目的:利用高场强氢质子磁共振波谱(1H-MRS)观察帕金森病大鼠模型纹状体区的神经代谢变化,探讨高场强1H-MRS对PD大鼠模型的应用价值。方法:7只正常大鼠经6-羟基多巴胺(6-OHDA)单侧(右侧)损毁制备偏侧帕金森病模型前后应用1.5T磁共振进行波谱分析。分析造模术前后双侧纹状体区N-乙酰天门冬氨酸/肌酸(NAA/Cr)、胆碱/肌酸(Cho/Cr)比值的变化。并对黑质致密部进行黑质酪氨酸羟化酶免疫组织化学染色。结果:6只大鼠造模成功。损毁侧纹状体内NAA/Cr比值明显低于对侧及造模前同侧(P<0.05),而Cho/Cr比值与对侧及造模前同侧相比无显著性差异(P>0.05)。损毁侧黑质酪氨酸羟化酶阳性神经元较对侧显著减少(P<0.05)。结论:1.5T临床专用型磁共振1H-MRS可以作为帕金森病大鼠模型纹状体区细胞代谢有价值的无创性检测方法。     

Inversion recovery MRI in idiopathic Parkinson disease is a very sensitive tool to assess neurodegeneration in the substantia nigra: preliminary investigation

RATIONALE AND OBJECTIVES: Segmented inversion recovery (IR) ratio imaging (SIRRIM) has been established as a sensitive tool to assess neurodegeneration of the substantia nigra pars compacta (SN(C)) in patients with idiopathic Parkinson disease (IPD). The obtained results suggest the possibility of magnetic resonance imaging (MRI) as a biological marker for IPD. The strength and a parsimonious analysis of the technique are discussed to assess the potential of using MRI as a biological marker for IPD and improve the differential diagnosis of sporadic Parkinson disease. Our hypothesis states that the magnetic resonance SIRRIM technique allows direct visualization and quantitation of neural cell loss in the SN(C) and therefore could become a reliable biological marker for Parkinson disease. To achieve this goal, some key aspects of data acquisition and data analysis need to be addressed. The clinical impact of the SIRRIM technique could be considerable, considering that it might become a viable surrogate to other techniques. PATIENTS AND METHODS: Twelve patients with IPD and 12 age-matched control subjects were imaged by using the SIRRIM technique based on two IR imaging sequences that were designed to suppress white and gray matter to assess loss of neural cells in situ by means of a ratio image (white matter suppressed image to gray matter suppressed image). The radiological index was correlated with the Unified Parkinson Disease Rating Scale (UPDRS) for patients with IPD. RESULTS: All patients with IPD were identified correctly, and full dichotomization between healthy volunteers and patients was obtained with our database. Our SIRRIM technique shows that it can be used to rule out Parkinson disease from essential tremor and other forms of Parkinsonism, such as progressive supranuclear palsy and multisystem atrophy. In addition, it is sensitive enough to identify patients with early-stage IPD. CONCLUSION: The hypothesis of using SIRRIM as a biological marker to assess IPD is supported by excellent correlation with clinical UPDRS scoring and has proved useful for the evaluation and quantitation of neurodegeneration with our SIRRIM technique, showing, in addition, that the differential diagnosis of IPD can be improved. Technical aspects of acquisition and data processing that need to be addressed can be overcome. It ultimately confirms that our objectives can be achieved and allows us to expect assessment of the progressive development of neurodegeneration in longitudinal studies and the putative neuroprotective approaches taken during the evolution of the disease.     

Differentiation of Parkinsonism-Predominant Multiple System Atrophy from Idiopathic Parkinson Disease Using 3T Susceptibility-Weighted MR Imaging,Focusing on Putaminal Change and Lesion Asymmetry

BACKGROUND AND PURPOSE:Asymmetric presentation of clinical feature in parkinsonism is common, but correlatable radiologic feature is not clearly defined. Our aim was to evaluate 3T susceptibility-weighted imaging findings for differentiating parkinsonism-predominant multiple system atrophy from idiopathic Parkinson disease, focusing on putaminal changes and lesion asymmetry.MATERIALS AND METHODS:This retrospective cohort study included 27 patients with parkinsonism-predominant multiple system atrophy and 50 patients with idiopathic Parkinson disease diagnosed clinically. Twenty-seven age-matched subjects without evidence of movement disorders who underwent SWI were included as the control group. A consensus was reached by 2 radiologists who visually assessed SWI for the presence of putaminal atrophy and marked signal hypointensity on each side of the posterolateral putamen. We also quantitatively measured putaminal width and phase-shift values.RESULTS:The mean disease duration was 4.7 years for the patients with parkinsonism-predominant multiple system atrophy and 7.8 years for the patients with idiopathic Parkinson disease. In the patients with parkinsonism-predominant multiple system atrophy, putaminal atrophy was frequently observed (14/27, 51.9%) and was most commonly found in the unilateral putamen (13/14). Marked signal hypointensity was observed in 12 patients with parkinsonism-predominant multiple system atrophy (44.4%). No patients with idiopathic Parkinson disease or healthy controls showed putaminal atrophy or marked signal hypointensity. Quantitatively measured putaminal width, phase-shift values, and the ratio of mean phase-shift values for the dominant and nondominant sides were significantly different between the parkinsonism-predominant multiple system atrophy group and the idiopathic Parkinson disease and healthy control groups (P < .001).CONCLUSIONS:3T SWI can visualize putaminal atrophy and marked signal hypointensity in patients with parkinsonism-predominant multiple system atrophy with high specificity. Furthermore, it clearly demonstrates the dominant side of putaminal changes, which correlate with the contralateral symptomatic side of patients.

Parkinsonism-predominant multiple system atrophy (MSA-p) is one of the Parkinson-plus syndromes that has a clinical manifestation similar to that of idiopathic Parkinson disease (IPD) and is often challenging to diagnose in its early stage. MR imaging plays a role in differentiating MSA-p from IPD and is included as an additional feature for the diagnosis of possible multiple system atrophy.¹ Various conventional and functional MR imaging findings regarding the putamen in MSA-p have been reported.^2–6 However, these findings had limited sensitivity and specificity.⁶An asymmetric presentation of clinical features is common for IPD in its early stage, while symmetric symptoms are more common in MSA-p than in IPD.^7,8 However, the clinical manifestation of parkinsonism develops asymmetrically in many patients with MSA-p, and it has been reported that approximately 40%–50% of patients with MSA-p present with initial asymmetric symptoms.^8,9 This presentation increases the difficulty of clinically differentiating IPD from MSA-p in the early stage of disease. However, to our knowledge, there are few previous reports that used imaging to examine the asymmetry of putaminal abnormalities in MSA-p.Susceptibility-weighted imaging (SWI), which was recently introduced and is now widely used in clinical brain imaging, reflects the physical magnetic properties of tissues because susceptibility changes in tissues, such as iron deposition, are very sensitive.¹⁰ In addition to the sensitivity of SWI to paramagnetic material, corrected phase images that are calculated to form final SWI can provide quantitative phase-shift values that reflect tissue iron content.¹¹ Recently published studies attempted to use SWI to differentiate movement disorders, including MSA-p,¹² and demonstrated different iron-deposition patterns between MSA-p and IPD by measuring phase-shift values by using corrected phase images of SWI sequences.¹³ However, most previous studies regarding SWI were performed on 1.5T or weaker main magnetic field MR imaging machines. When main magnetic field is increased to 3T, spins process at a higher frequency, which may result in phase shifts caused by susceptibility changes being more exaggerated on SWI.Thus, the purpose of the present study was to evaluate the imaging findings of 3T SWI for differentiating MSA-p from IPD, focusing on putaminal changes and lesion asymmetry.     

Proton MR spectroscopy of the brain in 14 patients with Parkinson disease.

PURPOSETo determine whether the proton spectra from patients with clinically diagnosed Parkinson disease differ from the spectra of age-matched healthy subjects with respect to the major cerebral metabolite resonances as well as lactate.METHODSFourteen patients with Parkinson disease (38 to 81 years of age) and 13 healthy control subjects (37 to 81 years of age) were studied using image-guided, single-voxel (27-cm3 volume) proton MR spectroscopy of the occipital lobe.RESULTSThe peak area ratios of N-acetyl aspartate to creatine and N-acetyl aspartate to choline for Parkinson patients did not show a statistically significant difference from the corresponding ratios for control subjects. There was a very significant increase in the ratio of lactate to N-acetyl aspartate for patients with Parkinson disease, with the greatest increase (threefold) manifested by the subgroup (n = 4) with dementia. The difference in N-acetyl aspartate to choline between women (n = 7) with Parkinson disease and healthy women (n = 9) approached significance. No dependence of the peak ratios on age, duration of Parkinson disease, or medication (L-dopa) regimen was found.CONCLUSIONPreliminary results indicating an increase in cerebral lactate in patients with Parkinson disease support the hypothesis that Parkinson disease is a systemic disorder characterized by an impairment of oxidative energy metabolism. The larger increases for Parkinson patients with dementia may be diagnostically useful in assessing clinical course and in differentiating Parkinson disease from other causes of dementia. Additional studies are needed, though, to quantitate lactate changes and identify potential contributions from lipid resonances better.     

Manganese-enhanced MRI in a rat model of Parkinson's disease

PURPOSE: To measure intra- and inter-hemispheric connectivity within the basal ganglia (BG) nuclei in healthy and in unilateral 6-hydroxydopamine (6-OHDA) Parkinson disease rat model in order to test the BG interhemispheric connectivity hypothesis. MATERIAL AND METHODS: The manganese-enhanced MRI (MEMRI) method with direct injection of manganese chloride into the entopeduncular (EP), substantia nigra (SN), and the Habenula nuclei in unilateral 6-OHDA (N = 22) and sham-operated (N = 16) rat groups was used. MEMRI measurements were applied before, 3, 24, and 48 hours post-manganese injection. Signal enhancements in T1-weighted images were compared between groups. RESULTS: Manganese injection into the EP nucleus resulted with bihemispheric signal enhancements in the habenular complex (Hab) at both groups with stronger enhancements in the 6-OHDA group. It also exhibited lower sensorimotor cortex signal enhancement in the 6-OHDA rat group. SN manganese injection caused enhanced anteroventral thalamic and habenular nuclei signals in the 6-OHDA rat group. Manganese habenula injection revealed enhanced interpeduncular (IP) and raphe nuclei signals of the 6-OHDA rat group. CONCLUSION: Modulations in the effective intra- and interhemispheric BG connectivity in unilateral 6-OHDA Parkinson's disease (PD) rat model support the BG interhemispheric connectivity hypothesis and suggest a linkage between the dopaminergic and serotonergic systems in PD, in line with clinical symptoms.     

Systemic lupus erythematosus: brain MR imaging and single-voxel hydrogen 1 MR spectroscopy

PURPOSE: To evaluate the usefulness of magnetic resonance (MR) imaging and hydrogen 1 MR spectroscopy in the detection of brain involvement in patients with systemic lupus erythematosus (SLE) with or without neuropsychiatric symptoms. MATERIALS AND METHODS: Twenty-six patients who had SLE with (n = 17) or without (n = 9) neuropsychiatric symptoms were examined at MR imaging and (1)H MR spectroscopy. The voxel was placed in the basal ganglia and peritrigonal white matter. Eight healthy volunteers were included. RESULTS: Five of nine patients with major neuropsychiatric symptoms and one of eight patients with minor neuropsychiatric symptoms had abnormal MR imaging findings. (1)H MR spectroscopy showed a significantly decreased N:-acetylaspartate-creatine (Cr) ratio in the basal ganglia and an increased choline-Cr ratio in the peritrigonal white matter in patients with major symptoms compared with those with minor symptoms, those without symptoms, and healthy control subjects. Among patients with major symptoms, there was no difference in metabolite ratios between those with and those without abnormal MR imaging findings. Among patients with normal MR imaging findings, abnormal spectral changes were observed only in those with major neuropsychiatric symptoms. In patients without neuropsychiatric symptoms, results of (1)H MR spectroscopy and MR imaging were normal. CONCLUSION: In patients with SLE, (1)H MR spectroscopic findings seem to reflect the cerebral metabolic disturbance related to the severity of the neuropsychiatric symptoms and are not related to the presence of abnormal MR imaging findings.     

Symptoms and imaging diagnostics of neurodegenerative dementia

A variety of neurodegenerative diseases can underlie dementia syndromes. In addition to Alzheimer??s disease (AD) and its prodromal stages, these include in particular frontotemporal degeneration, Lewy body dementia and Parkinson??s dementia, progressive supranuclear paresis, corticobasal degeneration and chorea Huntington. Although not classified as a neurodegenerative brain disease, for all clinical diagnoses there must be a differential diagnostic separation from vascular forms of dementia. Furthermore an exclusion of affective disorders, such as minor depression is necessary from a clinical psychiatric perspective. Moreover the preclinical stages of AD often present with uncharacteristic symptoms. Especially affective symptoms can occur in addition to initial cognitive deficits such as memory decline. In summary, clinical and neuropsychological procedures together with functional imaging techniques allow a detailed diagnostic assessment of neurodegenerative dementia syndromes which can be additionally supported by neurochemical biomarkers and innovative imaging procedures, such as diffusion imaging or magnetic resonance spectroscopy.     

血管性帕金森综合征与帕金森病的临床特点与影像学特征比较

 目的 对比血管性帕金森综合征(vascular Parkinson’s syndrome,VP)与帕金森病(Parkinson’s disease,PD)临床特点及影像学特征。方法 收集我院神经内科收治的70例VP患者作为VP组;同期来我院治疗的70例PD患者为PD组,记录并比较两组现病史(高血压病、冠心病、高脂血症、糖尿病、脑卒中),临床症状(静止性震颤、行走困难、步态不稳、偏侧躯体感觉障碍),以及头颅影像学改变。结果 VP组和PD组高血压病、冠心病、高脂血症、糖尿病、脑卒中发病率分别为(46%、52%、54%、40%、57%)、(30%、27%、28%、22%、38%),差异有统计学意义(P<0.05);PD组以静止性震颤为主,与VP组差异有统计学意义(P<0.05),而VP组以行走困难、步态不稳为主要表现,与PD组比较,差异有统计学意义(P<0.05);VP组老年性脑改变数量、梗死灶数量明显多于PD组,差异有统计学意义(P<0.05)。结论 高血压病、冠心病、高脂血症、糖尿病、脑卒中为VP的危险因素,VP临床症状及影像学改变不同于PD。     

MR imaging of Parkinson disease with spin-echo and gradient-echo sequences

High-field MR with both spin-echo and gradient-echo sequences was performed in 21 patients with (idiopathic, drug-responsive) Parkinson disease. The use of gradient echoes allowed more sensitive detection than did spin echoes of susceptibility changes in the putamina and substantia nigra. No statistically significant difference in putaminal hypointensity on long TR/long TE spin-echo sequences or on T2*-weighted images using gradient-echo sequences was observed between Parkinson patients and controls. There was also no statistically significant difference in the frequency of restoration of the signal intensity of the substantia nigra between the two groups of patients. The width of the pars compacta of the substantia nigra in patients with Parkinson disease was 2.12 + 0.82 mm (mean +/- SD). This value in age- and gender-matched controls was 2.67 +/- 0.5. Comparing these two groups with an unpaired t test resulted in a p value less than or equal to .005. Our MR study with spin-echo and gradient-echo images in Parkinson and control patients was able to substantiate and elaborate on previously described MR features of Parkinson disease.