Proton MR spectroscopy in Wilson disease: analysis of 36 cases.
OBJECTIVE
Wilson disease (WD) is rare but one of the few metabolic disorders that can possibly benefit from effective available treatments. The literature regarding proton MR spectroscopy (MRS) in WD is scarce and controversial. The purpose of this study was to determine the brain metabolic changes due to WD by using MRS. To our knowledge, this is the first time that MRS was performed in such a large sample of patients with WD.


METHODS
Thirty-six patients with WD and 37 healthy volunteers were examined with MRS in the parieto-occipital cortex, frontal white matter, and basal ganglia (BG). Ratios of the following metabolites were calculated in relation to creatine (Cr): N-acetylaspartate (NAA), choline (Cho), myo-inositol (mI), and glutamine/glutamate (Glx). The mean peak line width was measured on each spectrum.


RESULTS
Compared with control subjects, patients with WD had significantly decreased NAA/Cr ratios in the three studied areas (P < .005) and an increased mI/Cr ratio in the BG (P < .001). Cho/Cr and Glx/Cr did not differ between the groups. The mean peak line in the BG was wider in patients than in control subjects.


CONCLUSIONS
WD is unequivocally associated with MRS changes that could possibly be assigned to neuronal loss (in the three studied areas), to gliosis, and to iron and/or copper deposition in the BG.
Lucato
Leandro T
LT
Department of Radiology, the Clinics Hospital of the University of Sao Paulo, School of Medicine, Brazil.
Otaduy
Maria Concepción G
MC
Barbosa
Egberto R
ER
Machado
Alexandre A C
AA
McKinney
Alexander
A
Bacheschi
Luiz A
LA
Scaff
Milberto
M
Cerri
Giovanni G
GG
Leite
Claudia C
CC
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006527:Hepatolenticular Degeneration / Q000378:metabolism*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D011446:Prospective Studies