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Differentiation of multiple system atrophy from idiopathic Parkinson's disease using proton magnetic resonance spectroscopy
Author(s) -
Davie C. A.,
Wenning G. K.,
Barker G. J.,
Tofts P. S.,
Kendall B. E.,
Quinn N.,
McDonald W. I.,
Marsden C. D.,
Miller D. H.
Publication year - 1995
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410370211
Subject(s) - proton magnetic resonance , atrophy , magnetic resonance imaging , nuclear magnetic resonance , nuclear magnetic resonance spectroscopy , parkinson's disease , medicine , spectroscopy , degenerative disease , pathology , disease , physics , radiology , astronomy
Proton magnetic resonance spectroscopy, localized to the lentiform nucleus, was carried out in 7 patients with the pure or predominantly striatonigral variant (SND) of multiple system atrophy (MSA), 5 patients with the olivopontocerebellar variant of MSA, 9 patients with a clinical diagnosis of idiopathic Parkinson's disease (IPD), and 9 healthy age‐matched controls. The MSA group with predominantly striatonigral involvement showed a significant reduction in the N ‐acetylaspartate (NAA)/creatine ratio (median, 1.19; range, 0.96–2.0; p < 0.02) compared with the NAA/creatine ratio (median, 1.82; range, 1.19–2.31; p > 0.5). The NAA/creatine ratio was markedly reduced in 6 of the SND patients and in only 1 IPD patient. The choline/creatine ratio was also significantly lower in the SND group (median, 1.02; range, 0.91–1.23; p < 0.04) compared with the control group (median, 1.22; range, 1.05–1.65). The IPD group showed a normal lentiform choline/creatine ratio (median, 1.13; range, 0.89–1.65; p = 0.25) compared with controls. The olivopontocerebellar group also showed a significant reduction in the NAA/creatine ratio from the lentiform nucleus (median, 1.47; range, 1.22–1.68; p < 0.01) compared with the controls as well as a nonsignificant reduction in the choline/creatine ratio (median, 0.93; range, 0.85–1.27; p < 0.4). In vivo quantification of absolute metabolite concentrations was possible in 7 MSA patients and 6 controls and confirmed an absolute reduction of choline‐containing compounds and NAA in the MSA group compared with controls with no significant difference in the creatine concentrations between the MSA groups probably reflects neuronal loss, occurring predominantly in the putamen. Proton magnetic resonance spectroscopy is a useful, noninvasive technique to help differentiate MSA from IPD.