A Proton Magnetic Resonance Spectroscopy Study On The Clinical Heterogeneity Of Idiopathic Parkinson’s Disease

Objective To investigate the changes of proton magnetic resonance spectroscopy onthe pallidum-putamen and thalamus of different heterogeneity of idiopathicparkinson’s disease,and expore the application value of1H-MRS on different subtypesof IPD.Methods To analyze the heterogeneity of31cases(male17,female14) ofIPD.According to the different motor symptons,patients were divided intotrmor-dominant IPD(18),and postural instability-gait disorder(PIGD)-dominantIPD(13).According to whether patients with severe complications(motorfluctuations,dyskinesia,gait freezing),patients were divided into early (uncomplicated)IPD(16),and late (complicated) IPD(15).The content of NAA,Cho and Cr inpallidum-putamen and thalamus in all cases were examined with1H-MRS,the ratiosof NAA/Cr and NAA/（Cr+Cho）were calculated,and,the statistical analysis wascarried on.Results: There was a significant reduction in ratio of NAA/Cr and NAA/（Cr+Cho）in the pallidum-putamen of the contralateral initial symptom of patients between thetrmor-dominant IPD and postural instability-gait disorder(PIGD)-dominant IPD(P<0.05). There was no significant difference in the ratio of NAA/Cr and NAA/（Cr+Cho）in the thalamus between he trmor-dominant IPD and posturalinstability-gait disorder(PIGD)-dominant IPD．On the other hand, there was asignificant reduction in ratio of NAA/Cr and NAA（/Cr+Cho）in the pallidum-putamenof the contralateral initial symptom of patients between the early IPD and the late IPD(P<0.05). but there was no significant difference in the ratio of NAA/Cr and NAA/（Cr+Cho）in thalamus between the early IPD and the late IPD as well.Conclusion1H-MRS can evaluate the condition of people with Parkinson’s Diseaseobjectively，and probably provide imaging evidence for the new clinicalclassification(early parkinson’s disease and late Parkinson’s disease) that EFNSrecommended;1H-MRS is expected to provide useful information on neuronal loss asa biomarker, which probably can help distinguish from different motor phenotype ofIPD; Combined with clinical classification of IPD and results of1H-MRS, maycontribute to individualized treatment and surgery.