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Brainstem metabolites in multiple system atrophy of cerebellar type: 3.0-T magnetic resonance spectroscopy study

Authors

  • Yuhei Takado MD,

    1. Center for Integrated Human Brain Science, Brain Research Institute, University of Niigata, Niigata, Japan
    2. Department of Neurology, Brain Research Institute, University of Niigata, Niigata, Japan
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  • Hironaka Igarashi MD, PhD,

    Corresponding author
    1. Center for Integrated Human Brain Science, Brain Research Institute, University of Niigata, Niigata, Japan
    • Center for Integrated Human Brain Sciences, Brain Research Institute, University of Niigata, 1-757 Asahimachi, Niigata 951-8585, Japan

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  • Kenshi Terajima MD, PhD,

    1. Center for Integrated Human Brain Science, Brain Research Institute, University of Niigata, Niigata, Japan
    2. Department of Neurology, Brain Research Institute, University of Niigata, Niigata, Japan
    3. Department of Medical Informatics, University of Niigata Medical and Dental Hospital, Niigata, Japan
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  • Takayoshi Shimohata MD, PhD,

    1. Department of Neurology, Brain Research Institute, University of Niigata, Niigata, Japan
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  • Tetsutaro Ozawa MD, PhD,

    1. Department of Neurology, Brain Research Institute, University of Niigata, Niigata, Japan
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  • Kouichirou Okamoto MD, PhD,

    1. Center for Integrated Human Brain Science, Brain Research Institute, University of Niigata, Niigata, Japan
    2. Department of Neurosurgery, Brain Research Institute, University of Niigata, Niigata, Japan
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  • Masatoyo Nishizawa MD, PhD,

    1. Center for Integrated Human Brain Science, Brain Research Institute, University of Niigata, Niigata, Japan
    2. Department of Neurology, Brain Research Institute, University of Niigata, Niigata, Japan
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  • Tsutomu Nakada MD, PhD

    1. Center for Integrated Human Brain Science, Brain Research Institute, University of Niigata, Niigata, Japan
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  • Relevant conflict of interest: Nothing to report. This study was supported by grants from the Ministry of Education, Culture, Sports, Science and Technology (Japan), and a grant from the Research Committee for Ataxic Diseases, Ministry of Health and Welfare.

Abstract

Background: The aim of this study was to find biomarkers of disease severity in multiple system atrophy of cerebellar type by imaging disease specific regions using proton magnetic resonance spectroscopy on a 3.0 T system.

Methods: We performed proton magnetic resonance spectroscopy separately in the pons and medulla on 12 multiple system atrophy of cerebellar type patients and 12 age and gender matched control subjects. The metabolite concentrations were estimated from single-voxel proton magnetic resonance spectra measured by point resolved spectroscopy, which were then correlated with clinical severity using Part I, II, and IV of the unified multiple system atrophy rating scale.

Results: Proton magnetic resonance spectroscopy showed that myo-inositol concentrations in both the pons and medulla were significantly higher in multiple system atrophy of cerebellar type patients compared to those of the control subjects (P < 0.05). By contrast, total N-acetylaspartate (the sum of N-acetylaspartate and N-acetylaspartylglutamate) and total choline compounds concentrations in both the pons and medulla were significantly lower in multiple system atrophy of cerebellar type patients compared to control subjects (P < 0.05). Creatine concentration in the pons was significantly higher in multiple system atrophy of cerebellar type patients compared to the control subjects (P < 0.05). Furthermore, a significant correlation was found between the myo-inositol/creatine ratio in the pons and clinical severity, defined by the sum score of unified multiple system atrophy rating scale (I+II+IV) (r = 0.76, P < 0.01).

Conclusion: Proton magnetic resonance spectroscopy, in conjunction with a 3.0 T system, can be feasible to detect part of pathological changes in the brainstem, such as gliosis and neuronal cell loss, and the metabolites can be used as biomarkers of clinical severity in multiple system atrophy of cerebellar type patients. © 2011 Movement Disorder Society

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