通过高分辨率质子磁共振波谱获得多发性硬化症和退行性痴呆的脑脊液代谢谱。

F Nicoli, J Vion-Dury, S Confort-Gouny, S Maillet, J L Gastaut, P J Cozzone
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摘要

采用400 MHz的体外高分辨率质子磁共振波谱(MRS)对19例多发性硬化症(MS)患者、12例退行性痴呆患者和17例对照患者的脑脊液(CSF)进行了分析。MS患者脑脊液代谢谱略有改变(乳酸和果糖浓度升高,肌酐和苯丙氨酸浓度降低),与鞘内炎症强度无关。脑脊液质子磁共振不能区分复发缓解型多发性硬化症和原发性进展型多发性硬化症。我们未在天然或冻干脑脊液中检测到任何特异性异常共振。痴呆患者的脑脊液代谢谱发生了更大的改变(乳酸、丙酮酸、丙氨酸、赖氨酸、缬氨酸、亮氨酸-异亮氨酸、酪氨酸、谷氨酰胺的浓度增加),这与阿尔茨海默病中已经描述的脑氧化代谢损伤一致。在痴呆患者的磁共振谱上检测到未分配的异常但非特异性或恒定的共振。阿尔茨海默病患者脑脊液肌醇浓度也升高。体外高分辨率脑脊液质子MRS作为体内质子MRS的补充,为探索脑脊液用于痴呆的鉴别和/或早期诊断提供了一种新颖的方法。
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Cerebrospinal fluid metabolic profiles in multiple sclerosis and degenerative dementias obtained by high resolution proton magnetic resonance spectroscopy.

We have analyzed the cerebrospinal fluid (CSF) of 19 patients with multiple sclerosis (MS), 12 patients with degenerative dementia and 17 control patients using in vitro high resolution proton magnetic resonance spectroscopy (MRS) at 400 MHz. The CSF metabolic profile is slightly modified in MS patients (increased lactate and fructose concentrations, decreased creatinine and phenylalanine concentrations) and is not correlated with the intensity of the intrathecal inflammation. Proton MRS of CSF does not differentiate relapsing-remitting MS and primary progressive MS. We have not detected any specific abnormal resonance in native or lyophilized CSF. The CSF metabolic profile of demented patients is much more altered (increased concentration of lactate, pyruvate, alanine, lysine, valine, leucine-isoleucine, tyrosine, glutamine) and is in agreement with a brain oxidative metabolism impairment as already described in Alzheimer's disease. Unassigned abnormal but non specific or constant resonances have been detected on MR spectra of demented patients. CSF inositol concentration is also increased in the CSF of patients with Alzheimer's disease. In vitro high resolution proton MRS of the CSF constitutes a new and original way to explore CSF for the differential and/or early diagnosis of dementias, as a complement to in vivo proton cerebral MRS.

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