title: Proton MR spectroscopy of the cerebellum and pons in patients with degenerative ataxia.
abstract: OBJECTIVE
  To investigate whether proton magnetic resonance (MR) spectroscopy is a useful complement to MR imaging in patients with degenerative ataxia.
  
  
  METHODS
  Brain MR imaging and single-voxel proton MR spectroscopy of the right cerebellar hemisphere and pons were performed in 30 patients with sporadic (n = 16) or inherited (n = 14) degenerative ataxia and in 20 healthy control subjects. Several indexes of brainstem and cerebellar atrophy were measured on MR images, as well as the N-acetylaspartate/creatine (NAA/Cr), choline/Cr (Cho/Cr), and myo-inositol/Cr (mI/Cr) ratios in the MR spectra. Differences between patients and subjects were evaluated with the Kruskal-Wallis and Mann-Whitney tests, whereas correlation of clinical, MR imaging, and spectroscopic data was assessed with nonparametric Spearman rank correlation.
  
  
  RESULTS
  Measurements of brainstem and cerebellar atrophy obtained from MR images revealed patients had olivopontocerebellar atrophy (OPCA) (n = 11), spinal atrophy (SA) (n = 8), or corticocerebellar atrophy (CCA) (n = 4). Seven patients did not fulfill the criteria for any group and were considered undefined. In patients with OPCA, the pontine and cerebellar NAA/Cr and Cho/Cr ratios were significantly decreased when compared with those of the control subjects. Pontine and cerebellar NAA/Cr ratios were also significantly reduced in patients with SA and CCA. Five patients with undefined ataxia had a substantial decrease of pontine or cerebellar NAA/Cr ratio when compared with that of the control subjects. In patients with OPCA, the pontine NAA/Cr ratio (but not the atrophy measurements) showed a correlation (P =.04) with disability.
  
  
  CONCLUSIONS
  MR spectroscopy is a useful complement to MR imaging in patients with degenerative ataxia.
authors: Section of Diagnostic Radiology, Department of Clinical Physiopathology, University of Florence, Viale Morgagni 85, 50134 Florence, Italy.
authors: Mario
authors: M
authors: Mascalchi
authors: Mirco
authors: M
authors: Cosottini
authors: Francesco
authors: F
authors: Lolli
authors: Fabrizio
authors: F
authors: Salvi
authors: Carlo
authors: C
authors: Tessa
authors: Marco
authors: M
authors: Macucci
authors: Michela
authors: M
authors: Tosetti
authors: Rosaria
authors: R
authors: Plasmati
authors: Alessandra
authors: A
authors: Ferlini
authors: Carlo Alberto
authors: CA
authors: Tassinari
authors: Natale
authors: N
authors: Villari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001259:Ataxia / Q000378:metabolism / Q000473:pathology*; D016022:Case-Control Studies; D002524:Cerebellar Ataxia / Q000378:metabolism / Q000473:pathology*; D002794:Choline / Q000378:metabolism; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007294:Inositol / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D011149:Pons / Q000378:metabolism / Q000473:pathology*; D011522:Protons; D018709:Statistics, Nonparametric
chemical_list: D011522:Protons; D001224:Aspartic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003404:Creatinine; D002794:Choline