The usage of proton magnetic resonance spectroscopy in Parkinson's disease.

BACKGROUND: Parkinson's disease is a degenerative disorder of the central nervous system resulting from neuronal loss in the substantia nigra (a region of the mid brain) and BSG. Proton magnetic resonance spectroscopy (1H-MRS) has been previously performed in Parkinson's disease (PD) to evaluate in vivo concentration of basal ganglia (BSG) and cerebral cortex metabolites. However this technique has never been used to evaluate the substantia nigra (SN) in PD patients. In this preliminary report, single voxel MRS of BSG and SN was performed in PD and normal control (non-PD) to evaluate the usage of MRS in PD patients. MATERIAL AND METHOD: Seventeen PD patients including 12 men and five women with a mean age 60.5 years (SD 9.4) and a mean duration of the disease 5.9 years (SD 4.2) based on Hoehn & Yahr stage I to III, and 14 healthy age-matched controls including eight men and six women with a mean age 55.5 years (SD 5.8) were enrolled. Patients with evidence of brain atrophy and cognitive impairment were excluded. RESULTS: A significant reduction in the NAA/Cr ratio was observed in the SN ofPD compared with controls (p < 0.05). BSG spectra did not allow any evaluation due to the presence of artifacts related to inorganic paramagnetic substances. CONCLUSION: 1H-MRS could be used as a sensitive tool for studying neuronal dysfunction in SN of PD patients and may be a useful technique to monitor the disease. The SN reduction of NAA/Cr ratio in PD patients may be the marker of neuronal loss in SN of patients with PD.

Clinical silent cerebral infarct (SCI) in patients with thalassemia diseases assessed by magnetic resonance imaging (MRI).

BACKGROUND: Silent cerebral infarct (SCI) could be detected on magnetic resonance imaging. It seems to be associated with the risk of stroke. Ischemic stroke has been reported in sickle cell anemia. Sickle red cell in hypoxic state associated with hypercoagulopathy is the risk factor of blood vessel occlusion leading to ischemic stroke. Hypercoagulable state has been documented in patients with beta thalassemia/Hb E disease, which their red cells are abnormal in deformity. OBJECTIVE: Explore SCI in patients with beta thalassemia/Hb E disease and provide a guideline for prevention of stroke. MATERIAL AND METHOD: Sixty-seven patients (29 males and 28 females, age 10-59 yrs, with a mean age of 31) with beta-thal/Hb E disease who were in the steady state without any neurological sign and symptom and no other associated stroke related disease such as DM, HT were included for MRI scanning. The cerebral MRI protocals were axial Flair, T2 Gre and 3DTOFMRA (3-dimension time of flight magnetic resonance angiography) of the brain. RESULTS: 67 patients (29 males and 28 females) with beta-thal/Hb E disease who were in the steady state without any neurological sign and symptom and no other associate stroke related disease such as DM, HT were included for MRI scanning. The ages of the patients were 10 to 59 years with a mean of 31 years. The abnormalities of the brain were found in 16 of 67 (24%). Most of the lesions were lacunar infarcts with varying amounts in the deep cerebral white matter. One cortical and subcortical infarct was observed with irregularity and stenosis of the intracranial vessels noted by MRA. All cases showed increased vascularity compared to the normal control subject. CONCLUSION: This preliminary prevalence of 24% of SCI in this genotype of thalassemia was higher than found in sickle cell disease (11%). It may be associated with coagulopathy and deformity of the red cell. Further study is needed.