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a Robert Steiner MR
Unit, Imperial College School of Medicine, Hammersmith Hospital, Du
Cane Road, London W12 0NN, UK, b Medical
Research Council Cyclotron Unit, Imperial College School of Medicine,
Hammersmith Hospital, Du Cane Rd, London W12 0NN, UK, c King's
College Hospital Medical School and Institute of Psychiatry, De
Crespigny Park, Denmark Hill, London SE5 8AF, UK
Correspondence to: Dr M T M Hu, Medical Research Council Cyclotron Unit, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Rd, London W12 0NN, UK. Telephone 0181 383 3710; Fax 0181 383 2029.
Received 12 October
1998 and in revised form 8 February 1999;
Accepted 16
February 1999
OBJECTIVES
To
investigate whether proton magnetic resonance spectroscopy
(1H MRS) can detect cortical dysfunction in non-demented
patients with Parkinson's disease, and to correlate changes with
cognitive function on formal neuropsychological testing.
METHODSMultivoxel
1H MRS was performed in 17 patients with levodopa
treated idiopathic Parkinson's disease with out clinical
dementia, and 10 age match ed control subjects. Measurements of
N-acetylaspartate (NAA)/choline (Cho), NAA/creatine+phosphocreatine
(Cr), and Cho/Cr were obtained from right and left temporoparietal
cortex and occipital cortex. Fourteen patients with Parkinson's
disease underwent a full battery of neuropsychological testing
including performance and verbal subtests of the WAIS-R, Boston naming
test, FAS test, and California verbal learning test.
RESULTSThere were
significant temporoparietal cortex reductions in NAA/Cr ratios in right
and left averaged spectra of the patients with Parkinson's disease
(p=0.012 after Bonferroni correction) and in spectra contralateral to
the worst clinically affected limbs of the patients with Parkinson's
disease compared with controls (p = 0.003 after Bonferroni correction).
There was a significant correlation between reduction in NAA/Cr ratios
and measures of global cognitive decline, occurring independently of
motor impairment (p=0.019).
CONCLUSIONSThis study
suggests that 1H MRS can detect temporoparietal cortical
dysfunction in non-demented patients with Parkinson's disease. Further
longitudinal studies are needed to investigate whether these
1H MRS changes are predictive of future cognitive
impairment in the subset of patients with Parkinson's disease who go
on to develop dementia, or occur as part of the normal Parkinson's
disease process.
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