Table 2.
Main results of MRS studies in Parkinson's disease and atypical parkinsonian disorders.
| MRS technique | Disease | Main results | Mean (SD) of metabolite ratios in controls | Mean (SD) of metabolite ratios in patients | Significant differences were indicated by the following: | Reference |
|---|---|---|---|---|---|---|
|
1HMRS at 1.5 T |
MSA-P and PD versus controls | Reduction of NAA/Cr ratios in the lentiform nucleus | NAA/Cr: 1.76 (0.96) |
NAA/CrMSA-P: 1.35 (0.29) NAA/CrPD: 1.82 (0.28) |
P < 0.02 MSA-P versus controls P > 0.05 PD versus controls | [17] |
|
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|
1HMRS at 1.5 T |
PSP, CBD, MSA, and VP versus controls | Reduction of NAA/Cr ratios in the more affected frontal cortex | NAA/Cr: 2.1 (0.2) |
NAA/CrPSP: 1.4 (0.5) NAA/CrCBD: 0.9 (0.4) NAA/CrMSA: 1.2 (0.2) NAA/CrVP: 1.7 (0.1) |
P < 0.01 PSP, MSA and VP versus controls; P < 0.001 CBD versus controls |
[37] |
| PSP, MSA, CBD, and PD versus controls | Reduction of NAA/Cr ratios in the more affected putamen | NAA/Cr: 2.2 (0.2) |
NAA/CrPSP: 1.4 (0.2) NAA/CrCBD: 1.0 (0.4) NAA/CrMSA: 1.8 (0.3) NAA/CrPD: 1.5 (0.2) |
P < 0.01 PSP and PD versus controls; P < 0.001 CBD versus controls; P < 0.05 MSA versus controls |
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|
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| Reduction of NAA levels in the putamen | NAA: 7.1 (1.6) mM |
NAAPSP: 5.26 (0.9) mM NAAMSA-P: 5.27 (0.6) mM NAAPD: 6.88 (1.2) mM |
P = 0.003 MSA-P versus controls P = 0.023 MSA-P versus PD P = 0.002 PSP versus controls P = 0.016 PSP versus PD |
|||
|
1HMRS at 1.5 T |
MSA-P and PSP versus controls and PD | Reduction of NAA levels in the pallidum | NAA: 6.52 (1.5) mM |
NAAPSP: 4.07 (1.0) mM NAAMSA-P: 5.54 (1.1) mM NAAPD: 6.36 (0.8) mM |
P < 0.001 PSP versus controls P < 0.001 PSP versus PD |
[38] |
| Reduction of NAA levels in the lentiform nucleus | NAA: 6.77 (1.2) mM |
NAAPSP: 4.6 (0.6) mM NAAMSA-P: 5.4 (0.7) mM NAAPD: 6.62 (0.8) mM |
P = 0.003 MSA-P versus controls P = 0.027 MSA-P versus versus PD P < 0.001 PSP versus controls P < 0.001 PSP versus PD |
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|
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|
1HMRS at 1.5 T |
MSA and PSP versus controls and PD | Reduction of NAA/Cho ratios in the lentiform nucleus | NAA/Cho: 2.02 (0.43) |
NAA/ChoMSA: 1.39 (0.31) NAA/ChoPSP: 1.45 (0.28) NAA/ChoPD: 1.82 (0.28) |
P < 0.001 MSA versus controls P < 0.001 PSP versus controls P < 0.001 MSA versus PD P < 0.05 PSP versus PD |
[39] |
|
1HMRS at 1.5 T |
MSA, PSP, and PD versus controls and MSA versus PD | Reduction of NAA/Cr ratios in the lentiform nucleus | NAA/Cr: 1.86 (0.29) |
NAA/CrMSA: 1.32 (0.30) NAA/CrPSP: 1.40 (0.17) NAA/CrPD: 1.65 (0.41) |
P < 0.001 MSA versus controls P < 0.001 PSP versus controls P < 0.05 PD versus controls P < 0.01 MSA versus PD |
|
|
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| 1HMRS at 3 T | MSA-C and MSA-P versus controls; MSA-P versus PD | Reduction of NAA/Cr ratios in the pontine basis | NA | NA |
P < 0.0001 MSA-C versus controls P < 0.0001 MSA-P versus controls P = 0.001 MSA-P versus PD |
[40] |
| MSA-P versus controls and PD | Reduction of NAA/Cr ratios in the putamen | NA | NA |
P = 0.009 MSA-P versus controls P = 0.002 MSA-P versus PD |
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| 3D 1HMRSI at 3 T | PD versus controls and ADPs | Lower NAA/Cr ratios in the rostral SN regions than those in the caudal SN regions | (NAA/Cr)ros: 2.56 (0.73) and (NAA/Cr)cau: 1.85 (0.51) |
In PD (NAA/Cr)ros: 1.97 (1.24) and (NAA/Cr)cau: 3.47 (2.37). In ADPs (NAA/Cr)ros: 2.29 (1.37) and (NAA/Cr)cau: 2.09 (0.92) |
P < 0.0001 PD versus controls; P < 0.0001 PD versus APDs | [41] |
| APDs versus controls | Lower NAA/Cr ratios in the caudal SN regions than those in the rostral SN regions | (NAA/Cr)ros: 2.56 (0.73) and (NAA/Cr)cau: 1.85 (0.51) |
(NAA/Cr)ros: 2.29 (1.37) and (NAA/Cr)cau: 2.09 (0.92) |
P = 0.977 APDs versus controls | ||
APDs: atypical parkinsonian disorders; CBD: corticobasal degeneration; Cho: choline-containing compounds; Cr: creatine + phosphocreatine; 1HMRS: proton magnetic resonance spectroscopy; 1HMRSI: proton magnetic resonance spectroscopy imaging; MRS: magnetic resonance spectroscopy; MSA: multiple-system atrophy; MSA-C: cerebellar ataxia variant of multiple-system atrophy; MSA-P: Parkinson's variant of multiple-system atrophy; NA: not applicable; NAA: N-acetylaspartate; PD: Parkinson's disease; PSP: progressive supranuclear palsy; SD: standard deviation; SN: substantia nigra; T: Tesla; VP: vascular parkinsonism.