Tremor Paralysis Type Multiple System Atrophy Quantitative Analysis Of Mr Brain Metabolites And Morphological Measurement And Analysis

Objective To evaluate the changes of metabolites concentration in brain of MSA-P patients measured with 1H-MRS and LCModel.Methods Single voxel point resolved spectroscopy sequence was performed in pons, the left basal ganglia and left precentral gyrus in 7 patients with probable MSA-P and 15 age-matched normal controls on a 3.0T magnetic resonance imaging system. The absolute concentrations of tNAA, ml, tCho and Cr as well as their ratios to Cr were measured with LCModel.Results The absolute concentration of ml in pons of the MSA-P group was significantly higher than that of control group (P=0.001). The absolute concentration of tNAA in left basal ganglia of the MSA-P group was significantly lower than that of control group (P=0.017). The ratio of tNAA/Cr in pons of the MSA-P group was significantly lower than that of control group (P=0.001). The absolute and relative concentration of other metabolites in the remaining parts showed no significant difference between MSA-P Objective To compare the absolute concentration of metabolites and their ratios to Cr between MSA and idiopathic Parkinson's disease(IPD). Methods Single voxel point resolved spectroscopy sequence was performed in pons, left putamen and left precentral gyrus in 7 probable MSA-P,7 age-matched IPD patients and 15 age-matched normal controls on a 3.0T magnetic resonance imaging system. The absolute concentration of tNAA, tCho, ml and Cr as well as their ratios to Cr were measured with LCModel.Results The absolute concentration of ml in pons of the MSA-P group was significantly higher than that of IPD group and control group (P=0.005 and 0.001 respectively). The ratio of tNAA/Cr in pons of the MSA-P group was significantly lower than that of IPD group and control group (P=0.000 and 0.000 respectively). The ratio of tNAA/(Cr+ml) in pons of MSA-P group was significantly lower than that of IPD group and control group (P=0.000 and 0.000 respectively). The absolute concentration of other metabolites and their ratios to Cr in remaining parts showed no significant difference between MSA-P and IPD patients as well as between MSA-P patients and normal controls. The absolute concentration of metabolistes and their ratios to Cr showed no significant difference between IPD group and control group at all regions.Conclusion There is difference in concentration of metabolites in pons between MSA-P Objective To assess patterns of the gray and white matter atrophy in patients with multiple system atrophy-P variant (MSA-P) of whole brain compared with normal controls.Methods 3D-FSPGR T1 weighted images of whole brain were obtained from 13 patients with probable MSA-P and 14 age-matched normal controls. The volume of gray matter(GM) and white matter of MSA-P patients and normal controls (WM) was compared with voxel-based morphometry (VBM) statistical parametric mapping (SPM) 8 was used. Results Compared with the controls, the MSA-P patients showed decreased gray matter and white matter in broad areas. Gray matter loss mainly symmetrically distributed in bilateral supplementary motor area (SMA), dorsal posterior cingulate cortex (DPCC), medial frontal gyrus, superior temporal gyrus, cerebellum cortex, etc. Unilateral involvment of cortices mainly located in right primary motor cortex, Somatosensory Association Cortex (SAC), and left ventral anterior cingulate cortex(VACC). There was white matter loss in bilateral superior frontal gyrus, bilateral precuneus, bilateral sub-gyrus of frontal Lobe, left superior temporal gyrus, left cingulate gyrus, right orbitofrontal area, right sub-gyrus of temporal lobe, etc.Conclusion VBM method is an automatic and comprehensive volumetry method and can objectively detect the difference of the whole brain structure in patients with probable MSA-P comparing with health controls.