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A Proton Magnetic Resonance Spectroscopy Study

Christopher Summerfield, MSc; Beatriz Gómez-Ansón, MD, PhD, FRCR; Eduardo Tolosa, MD, FRCP; José M. Mercader, MD; M. Jose Martí, MD; Pau Pastor, MD; Carme Junqué, PhD

Arch Neurol. 2002;59:1415-1420.

Background  Magnetic resonance spectroscopy has been shown to be useful in differentiating idiopathic Parkinson disease (PD) from atypical parkinsonian syndromes such as progressive supranuclear palsy, multiple system atrophy, and corticobasal degeneration.

Objective  To systematically investigate the utility of proton magnetic resonance spectroscopy in distinguishing between idiopathic PD with dementia (PDD) and without dementia.

Design  Group comparisons and correlations of brain metabolites with clinical and neuropsychological variables.

Patients and Methods  Metabolite concentrations were acquired from voxels localized to the basal ganglia and occipital cortex in 14 patients diagnosed as having idiopathic PDD, 12 patients with PD without dementia, and 13 matched control subjects. The 3 groups underwent clinical and neuropsychological assessment.

Results  In the occipital region, N-acetylaspartate levels were significantly reduced in the PDD group relative to the PD and control groups. N-acetylaspartate values correlated with neuropsychological performance but not with severity of motor impairment.

Conclusions  N-acetylaspartate reduction in occipital lobes may be a marker for dementia in PD. The distribution of metabolite reduction differs from that reported in Alzheimer disease. These findings suggest that proton spectroscopy may serve as a metabolic marker of cognitive disturbance in patients with PD.

From the Department of Psychiatry and Clinical Psychobiology (Mr Summerfield and Dr Junqué), Neurology Department, Institut de Malalties del Sistema Nervios, Hospital Clinic (Drs Tolosa, Martí, and Pastor), and Radiology Department, CDI, Hospital Clinic (Drs Gómez-Ansón and Mercader), University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.