title: Proton magnetic resonance spectroscopic imaging in patients with cerebellar degeneration.
abstract: Using proton magnetic resonance spectroscopic imaging, we studied the cerebellum of 9 patients with cerebellar degeneration and of 9 age-matched normal control subjects. This technique permits the simultaneous measurement of N-acetylaspartate, choline-containing compounds, creatine/phosphocreatine, and lactate signal intensities from four 15-mm slices divided into 0.84-ml single-volume elements. Because patients with cerebellar degeneration often show substantial atrophy on magnetic resonance imaging (MRI), we specifically chose to analyze the spectroscopic signals only from tissue that did not have an atrophic appearance on the MRI. The spectroscopic findings showed a significant reduction of N-acetylaspartate in all parts of the cerebellum, a significant correlation with MRI scores of cerebellar atrophy, and a significant correlation with clinical rating scores of cerebellar disturbance. Our method of analysis suggests the presence of a neurodegenerative process in cerebellar areas that do not appear to be atrophic on the MRI. Some limitations of proton magnetic resonance spectroscopic imaging in the present study were related to the partial field inhomogeneity characteristics of the posterior fossa, the anatomical location of the cerebellum, and the particularly severe cerebellar atrophy in some of the patients.
authors.affiliation: Neuroimaging Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: G
authors.initials: G
authors.lastname: Tedeschi
authors.forename: A
authors.initials: A
authors.lastname: Bertolino
authors.forename: S G
authors.initials: SG
authors.lastname: Massaquoi
authors.forename: G
authors.initials: G
authors.lastname: Campbell
authors.forename: N J
authors.initials: NJ
authors.lastname: Patronas
authors.forename: S
authors.initials: S
authors.lastname: Bonavita
authors.forename: A S
authors.initials: AS
authors.lastname: Barnett
authors.forename: J R
authors.initials: JR
authors.lastname: Alger
authors.forename: M
authors.initials: M
authors.lastname: Hallett
mesh_terms: D000328:Adult; D000368:Aged; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001284:Atrophy; D002526:Cerebellar Diseases / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D002531:Cerebellum / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D006801:Humans; D007773:Lactates / Q000378:metabolism; D019344:Lactic Acid; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008875:Middle Aged; D009410:Nerve Degeneration; D011522:Protons; D012720:Severity of Illness Index
chemical_list: D007773:Lactates; D011522:Protons; D001224:Aspartic Acid; D019344:Lactic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline