[Value of 1H-MRS on SCA3/MJD diagnosis and clinical course]

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017 Mar 28;42(3):291-297. doi: 10.11817/j.issn.1672-7347.2017.03.009.
[Article in Chinese]

Abstract

To investigate the value of proton magnetic resonance spectroscopy (1H-MRS) on the diagnosis of SCA3/MJD, and to calculate the correlation between 1H-MRS ratio and the clinical score. Methods: Sixteen patients with SCA3/MJD and 19 healthy volunteers were scanned with 1H-MRS. The data of N-acetyl aspartate, creatine, choline-containing compounds, myoinositol, NAA/Cr, Cho/Cr, and mI/Cr ratio were collected, which were grouped for comparative study. The onset patients with SCA3/MJD were evaluated with the International Cooperative Ataxia Rating Scale and Scale for the Assessment and Rating of Ataxia, the correlation between NAA/Cr, Cho/Cr or mI/Cr ratio and the clinical score was calculated. Results: The NAA/Cr in the pons and cerebellar dentate nucleus from the onset patients with SCA3/MJD was significantly reduced compared to that in the normal control group. The NAA/Cr in the cerebellar dentate nucleus of onset patients with SCA3/MJD was obviously correlated with ICARS. Conclusion: SCA3/MJD lesions are mainly located in the cerebellum and brainstem, where gray and white mater are also involved. The cerebellar dentate nucleus may be the earliest involved area. There is a correlation between the ICARS and the cerebellar lesion degree. The ICARS reflects the severity of clinical manifestations. 1H-MRS is useful in the diagnosis of SCA3/MJD.

目的:探讨氢质子波谱(proton magnetic resonance spectroscopy,1H-MRS)在脊髓小脑型共济失调3型/马查多–约瑟夫病(hereditary spinocerebellar ataxias 3 and Machado-Joseph,SCA3/MJD)诊断中的价值,同时探讨其与临床病程评分之间的联系。方法:SCA3/MJD起病患者、SCA3/MJD未起病患者及年龄匹配健康志愿者进行1H-MRS检查,经数据后处理获得N–乙酰天门冬氨酸(N-acetylaspartate,NAA),肌酸(creatine,Cr),胆碱(choline-containing compounds,Cho),肌醇(myo-inositol,mI)值及NAA/Cr,Cho/Cr,mI/Cr比值。将以上数据进行对比研究;同时对于SCA3/MJD起病患者进行国际协作共济失调评估量表(International Cooperative Ataxia Rating Scale,ICARS)及共济失调等级量表(Scale for the Assessment and Rating of Ataxia,SARA)评估,计算NAA/Cr,Cho/Cr,mI/Cr比值与临床评分之间的相关性。 结果:SCA3/MJD起病患者在桥脑及齿状核的NAA/Cr值较正常对照组明显减低。SCA3/MJD起病患者小脑齿状核NAA/Cr值与ICARS评分有明显相关性。结论:SCA3/MJD的病变主要位于小脑及脑干,ICARS评分与小脑病变的程度有相关性,能较好地反映临床表现的轻重程度。1H-MRS 对于SCA3/MJD 的诊断有一定的应用前景。.

MeSH terms

  • Aspartic Acid / analysis
  • Brain Stem / chemistry
  • Brain Stem / diagnostic imaging
  • Case-Control Studies
  • Cerebellar Nuclei / chemistry
  • Cerebellar Nuclei / diagnostic imaging
  • Cerebellum / chemistry
  • Cerebellum / diagnostic imaging
  • Choline / analysis
  • Creatine / analysis
  • Humans
  • Machado-Joseph Disease / diagnostic imaging*
  • Machado-Joseph Disease / metabolism
  • Magnetic Resonance Spectroscopy
  • Pons / chemistry
  • Pons / diagnostic imaging
  • Proton Magnetic Resonance Spectroscopy*

Substances

  • Aspartic Acid
  • Creatine
  • Choline