Metabolic Alterations in Parkinson's Disease After Thalamotomy, as Revealed by 1H MR Spectroscopy
Objective: To determine, using proton magnetic resonance spectroscopy ( 1H MRS) whether thalamotomy in patients with Parkinson's disease gives rise to significant changes in regional brain metabolism. Materials and Methods: Fifteen patients each underwent stereotactic thalamotomy for the control of medically refractory parkinsonian tremor. Single-voxel 1H MRS was performed on a 1.5T unit using a STEAM sequence (TR/TM/TE, 2000/14/20 msec), and spectra were obtained from substantia nigra, thalamus and putamen areas, with volumes of interest of 7-8ml, before and after thalamotomy. NAA/Cho, NAA/Cr and Cho/Cr metabolite ratios were calculated from relative peak area measurements, and any changes were recorded and assessed. Results: In the substantia nigra and thalamus, NAA/Cho ratios were generally low. In the substantia nigra of 80% of patients (12/15) who showed clinical improvement, decreased NAA/Cho ratios were observed in selected voxels after thalamic surgery (< 0.05). In the thalamus of 67% of such patients (10/15), significant decreases were also noted (< 0.05). Conclusion: Our results suggest that the NAA/Cho ratio may be a valuable criterion for the evaluation of Parkinson's disease patients who show clinical improvement following surgery. By highlighting variations in this ratio, 1H MRS may help lead to a better understanding of the pathophysiologic processes occurring in those with Parkinson's disease.
H. Baik et al., "Metabolic Alterations in Parkinson's Disease After Thalamotomy, as Revealed by 1H MR Spectroscopy," Korean Journal of Radiology, Korean Radiological Society, Jan 2002.
The definitive version is available at http://dx.doi.org/10.3348/kjr.2002.3.3.180
Mining and Nuclear Engineering
Keywords and Phrases
Metabolism; Parkinson's Disease; Proton Magnetic Resonance Spectroscopy ( 1H MRS); Thalamotomy
Article - Journal
© 2002 Korean Radiological Society, All rights reserved.