Journal of the Korean Magnetic Resonance Society (한국자기공명학회논문지)

Korean Magnetic Resonance Society (한국자기공명학회)
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Neurometabolic Improvement in Parkinson's Disease after Stereotactic Functional Neurosurgery by Follow-up MR Spectroscopy

  • Choe, Bo-Young (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam St. Mary′s Hospital, College of Medicine, the Catholic University) ;
  • Baik, Hyeon-Man (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam St. Mary's Hospital, College of Medicine, the Catholic University) ;
  • Jeun, Sin-Soo (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam St. Mary's Hospital, College of Medicine, the Catholic University) ;
  • Son, Byung-Chul (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam St. Mary's Hospital, College of Medicine, the Catholic University) ;
  • Kim, Moon-Chan (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam St. Mary's Hospital, College of Medicine, the Catholic University) ;
  • Kim, Bum-Soo (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam St. Mary's Hospital, College of Medicine, the Catholic University) ;
  • Lee, Jae-Moon (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam St. Mary's Hospital, College of Medicine, the Catholic University) ;
  • Lee, Hyoung-Koo (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam St. Mary's Hospital, College of Medicine, the Catholic University) ;
  • Suh, Tae-Suk (Departments of Biomedical Engineering, Neurosurgery and Radiology, Kangnam St. Mary's Hospital, College of Medicine, the Catholic University)
  • Published : 2003.06.01
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Abstract

PURPOSE - To investigate neurometabolism from the brain destructive lesions and striatal putamen-pallidus regions to the clinically worst side in patients with Parkinson's disease after stereotactic functional neurosurgery. METHODS - Using proton magnetic resonance spectroscopy ($^1$H MRS), fifteen patients (7 males and 8 females; mean age 56.5 years; age range 43-67 years) with Parkinson's disease (PD) were studied to measure N-acetylaspartate (NAA), creatine (Cr), choline-containing compounds (Cho) and lactate (Lac) levels on the neurosurgical lesions of thalamus, globus pallidus and striatal putamen-pallidus regions in a brain. RESULTS - Brain destructive lesion and striatal putamen-pallidus region in PD compared with controls were highly and significantly related to NAA/Cho ratios reduction, respectively (P =0.002, P =0.04), but showed no difference from the same regions of PD prior to neurosergery (P =0.06, P =0.77). Increased lactate peaks at 1.3 ppm were present in all the cerebral lesions, and these resonances were confirmed at a long TE =136 ms, indicating that these signals distinguished from lipids. CONCLUSIONS - Our results suggest that NAA/Cho ratios may provide as a neurometabolite marker for neurochemical changes in brain surgical lesion, and the ratios might be related to functional change of neuropathophysiological status in the striatal putamen-pallidus region of PD. Increase of lactate signals, being remarkable in surgical lesions, could be consistent with a common consequence of surgical necrosis. Therefore, MR spectroscopy could be a sensitive diagnostic tool in monitoring neurometabolic changes in PD with neurosurgical treatment.

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