Journal of the Korean Magnetic Resonance Society (한국자기공명학회논문지)

Korean Magnetic Resonance Society (한국자기공명학회)
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Metabolic Changes in Patients with Parkinson's Disease after Stereotactic Neurosurgery by Follow-up 1H MR Spectroscopy

  • Choe, Bo-Young (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam st. Mary's Hospital, College of Medicine, the Catholic University of Korea) ;
  • Baik, Hyun-Man (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam st. Mary's Hospital, College of Medicine, the Catholic University of Korea) ;
  • Chun, Shin-Soo (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam st. Mary's Hospital, College of Medicine, the Catholic University of Korea) ;
  • Son, Byung-Chul (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam st. Mary's Hospital, College of Medicine, the Catholic University of Korea) ;
  • Kim, Moon-Chan (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam st. Mary's Hospital, College of Medicine, the Catholic University of Korea) ;
  • Kim, Bum-Soo (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam st. Mary's Hospital, College of Medicine, the Catholic University of Korea) ;
  • Lee, Hyoung-Koo (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam st. Mary's Hospital, College of Medicine, the Catholic University of Korea) ;
  • Suh, Tae-Suk (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam st. Mary's Hospital, College of Medicine, the Catholic University of Korea)
  • Published : 2001.12.01
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Abstract

Authors investigated neuronal changes of local cellular metabolism in the cerebral lesions of Parkinsonian symptomatic side between before and after stereotactic neurosurgery by follow-up 1H magnetic resonance spectroscopy (MRS). Patients with Parkinson's disease (PD) (n = 15) and age-matched normal controls (n = 15) underwen MRS examinations using a stimulated echo acquisition mode (STEAM) pulse sequence that provided 2${\times}$2${\times}$2 ㎤ (8ml) volume of interest in the regions of substantia nigra, thalamus, and lentiform nucleus. Spectral parameters were 20 ms TE, 2000 ms TR, 128 averages,2500 Hz spectral width, and 2048 data points. Raw data were processed by the SAGE data analysis package (GE Medical Systems). Peak areas of N-acetylaspartate (NAA), creatine (Cr), choline-containing compounds (Cho), inositols (Ins), and the sum (Glx) of glutamate and GABA were calculated by means of fitting the spectrum to a summation of Lorentzian curves using Marquardt algorithm. After blindly processed, we evaluated neuronal alterations of observable metabolite ratios between before and after stereotactic neurosurgery using Pearson product-moment analysis (SPSS, Ver. 6.0). A significant reduction of NAA/Cho ratio was observed in the cerebral lesion in substantia nigra of PD patient related to the symptomatic side after neurosurgery (P : 0.03). In thalamus, NAA/Cho ratio was also significantly decreased in the cerebral lesion including the electrode-surgical region (P : 0.03). A significant reduction of NAA/Cho ratio in lentiform nucleus was not oberved, but tended toward significant reduction after neurosurgery (P = 0.08). In particular, remarkable lactate signal was noted from the surgical thalamic lesions of 6 among 8 patients and internal segments of globus pallidus of 6 among 7 patients, respectively. Significant metabolic alterations of NAA/Cho ratio might reflect functional changes of neuropathological processes in the lesion of substantia nigra, thalamus, and lentiform nucleus, and could be a valuable finding fur evaluation of Parkinson's disease after neurosurgery. Increase of lactate signals, being remarkable in surgical lesions, could be consistent with a common consequence of neurosurgical necrosis. Thus, IH MRS could be a useful modality to evaluate the diagnostic and prognostic implications fur Parkinsons disease after functional neurosurgery.

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