Choe, Bo-Young;Baik, Hyun-Man;Son, Byung-Chul;Kim, Moon-Chan;Kim, Euy-Neyung;Suh, Tae-Suk;Lee, Hyoung-Koo;Shinn, Kyung-Sub
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Authors evaluated alterations of observable metabolite ratios between the cerebral lesion and the contralateral region related to the clinical symptomatic side in levodopa-treated Parkinson's disease (PD) and investigated correlation between age in patients with PD and metabolite ratios of the lesion. Patients with levodopa-treated PD (n = 54) and age-matched normal controls (n = 15) underwent magnetic resonance spectroscopy (MRS) examinations using a stimulated echo acquisition mode (STEAM) pulse sequence that provided 2$\times$2$\times$2 cm3 volume of interest in the selected regions of substantia nigra (SN) and putamed-globus pallidus (PG). To evaluate dependence of metabolite ratios on age, we divided into two groups (i.e., younger and older age). We quantitatively measured N-acetylaspartate (NAA), creatine (Cr), choline-containing compounds (Cho), inositols (Ins), and the sum of glutamate (Glx) and GABA levels and obtained proton metabolite ratios relative to Cr using a Marquart algorithm. Compared with the contralateral region, a significant neuronal laterality of the NAA/Cr ratio in the lesion of SN related to the clinical symptomatic side was established (P = 0.01), but was not established in the lesion of PG (P = 0.24). Also, Cho/Cr ratio tended toward significance in the lesion of SN (P = 0.07) and was statistically significant in the lesion of PG(P = 0.01). Compared with that in the younger age group, NAA/Cr ratio in the older age was decreased in the lesion of SN (P = 0.02), while NAA/Cr ratio was not statistically significant in the lesion of PG ( P = 0.21). Significant metabolic alterations of NAA/Cr and Cho/Cr ratios might be closely related with functional changes of neuropathological process in SN and PG of levodopa treated PD and could be a valuable finding for evaluation of the PD. A trend of NAA/Cr reduction, being statistically significant in older patients, could be indicative of more pronounced neuronal damage in the SN of the progressive PD.