Altered neurometabolic profile in early Parkinson's disease

A study with short echo-time whole brain MR spectroscopic imaging

Martin Klietz, Paul Bronzlik, Patrick Nösel, Florian Wegner, Dirk W. Dressler, Mete Dadak, Andrew A Maudsley, Sulaiman Sheriff, Heinrich Lanfermann, Xiao Qi Ding

Research output: Contribution to journalArticle

Abstract

Objective: To estimate alterations in neurometabolic profile of patients with early stage Parkinson's disease (PD) by using a short echo-time whole brain magnetic resonance spectroscopic imaging (wbMRSI) as possible biomarker for early diagnosis and monitoring of PD. Methods: 20 PD patients in early stage (H&Y ≤ 2) without evidence of severe other diseases and 20 age and sex matched healthy controls underwent wbMRSI. In each subject brain regional concentrations of metabolites N-acetyl-aspartate (NAA), choline (Cho), total creatine (tCr), glutamine (Gln), glutamate (Glu), and myo-inositol (mIns) were obtained in atlas-defined lobar structures including subcortical basal ganglia structures (the left and right frontal lobes, temporal lobes, parietal lobes, occipital lobes, and the cerebellum) and compared between patients and matched healthy controls. Clinical characteristics of the PD patients were correlated with spectroscopic findings. Results: In comparison to controls the PD patients revealed altered lobar metabolite levels in all brain lobes contralateral to dominantly affected body side, i.e., decreases of temporal NAA, Cho, and tCr, parietal NAA and tCr, and frontal as well as occipital NAA. The frontal NAA correlated negatively with the MDS-UPDRS II (R = 22120.585, p = 0.008), MDS-UPDRS IV (R = −0.458, p = 0.048) and total MDS-UPDRS scores (R = −0.679, p = 0.001). Conclusion: In early PD stages metabolic alterations are evident in all contralateral brain lobes demonstrating that the neurodegenerative process affects not only local areas by dopaminergic denervation, but also the functional network within different brain regions. The wbMRSI-detectable brain metabolic alterations reveal the potential to serve as biomarkers for early PD.

Original languageEnglish (US)
Article number777
JournalFrontiers in Neurology
Volume10
Issue numberJUL
DOIs
StatePublished - Jan 1 2019

Fingerprint

Parkinson Disease
Brain
Creatine
Magnetic Resonance Imaging
Choline
Biomarkers
Occipital Lobe
Parietal Lobe
Atlases
Frontal Lobe
Denervation
Inositol
Temporal Lobe
Basal Ganglia
Glutamine
Cerebellum
Early Diagnosis
Glutamic Acid
N-acetylaspartate

Keywords

  • Biomarker
  • Early diagnosis
  • MRI
  • Parkinson's disease
  • Spectroscopy
  • Whole brain

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Altered neurometabolic profile in early Parkinson's disease : A study with short echo-time whole brain MR spectroscopic imaging. / Klietz, Martin; Bronzlik, Paul; Nösel, Patrick; Wegner, Florian; Dressler, Dirk W.; Dadak, Mete; Maudsley, Andrew A; Sheriff, Sulaiman; Lanfermann, Heinrich; Ding, Xiao Qi.

In: Frontiers in Neurology, Vol. 10, No. JUL, 777, 01.01.2019.

Research output: Contribution to journalArticle

Klietz, M, Bronzlik, P, Nösel, P, Wegner, F, Dressler, DW, Dadak, M, Maudsley, AA, Sheriff, S, Lanfermann, H & Ding, XQ 2019, 'Altered neurometabolic profile in early Parkinson's disease: A study with short echo-time whole brain MR spectroscopic imaging', Frontiers in Neurology, vol. 10, no. JUL, 777. https://doi.org/10.3389/fneur.2019.00777
Klietz, Martin ; Bronzlik, Paul ; Nösel, Patrick ; Wegner, Florian ; Dressler, Dirk W. ; Dadak, Mete ; Maudsley, Andrew A ; Sheriff, Sulaiman ; Lanfermann, Heinrich ; Ding, Xiao Qi. / Altered neurometabolic profile in early Parkinson's disease : A study with short echo-time whole brain MR spectroscopic imaging. In: Frontiers in Neurology. 2019 ; Vol. 10, No. JUL.
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abstract = "Objective: To estimate alterations in neurometabolic profile of patients with early stage Parkinson's disease (PD) by using a short echo-time whole brain magnetic resonance spectroscopic imaging (wbMRSI) as possible biomarker for early diagnosis and monitoring of PD. Methods: 20 PD patients in early stage (H&Y ≤ 2) without evidence of severe other diseases and 20 age and sex matched healthy controls underwent wbMRSI. In each subject brain regional concentrations of metabolites N-acetyl-aspartate (NAA), choline (Cho), total creatine (tCr), glutamine (Gln), glutamate (Glu), and myo-inositol (mIns) were obtained in atlas-defined lobar structures including subcortical basal ganglia structures (the left and right frontal lobes, temporal lobes, parietal lobes, occipital lobes, and the cerebellum) and compared between patients and matched healthy controls. Clinical characteristics of the PD patients were correlated with spectroscopic findings. Results: In comparison to controls the PD patients revealed altered lobar metabolite levels in all brain lobes contralateral to dominantly affected body side, i.e., decreases of temporal NAA, Cho, and tCr, parietal NAA and tCr, and frontal as well as occipital NAA. The frontal NAA correlated negatively with the MDS-UPDRS II (R = 22120.585, p = 0.008), MDS-UPDRS IV (R = −0.458, p = 0.048) and total MDS-UPDRS scores (R = −0.679, p = 0.001). Conclusion: In early PD stages metabolic alterations are evident in all contralateral brain lobes demonstrating that the neurodegenerative process affects not only local areas by dopaminergic denervation, but also the functional network within different brain regions. The wbMRSI-detectable brain metabolic alterations reveal the potential to serve as biomarkers for early PD.",
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