Abstract
OBJECTIVES—10 patients with Niemann-Pick disease type C (NP-C) were studied by proton magnetic resonance spectroscopic imaging (1H-MRSI) to assess the biochemical pathology of the brain and to determine whether this method can be useful to clinically evaluate these patients. METHODS—1H-MRSI permits the simultaneous measurement of N-acetyl aspartate (NA), compounds containing choline (Cho), creatine plus phosphocreatine (Cre), and lactate (Lac) signal intensities from four 15 mm slices divided into 0.84 ml single volume elements. Spectroscopic voxels were identified from seven regions of interest. RESULTS—In patients with NP-C, NA/Cre was significantly decreased in the frontal and parietal cortices, centrum semiovale, and caudate nucleus; Cho/Cre was significantly increased in the frontal cortex and centrum semiovale. Significant correlations were found between clinical staging scale scores and 1H-MRSI abnormalities. CONCLUSION—1H-MRSI showed diffuse brain involvement in patients with NP-C consistent with the pathological features of the disease. 1H-MRSI is an objective and sensitive tool to neurologically evaluate patients with NP-C.
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- Arnold D. L., Matthews P. M., Francis G. S., O'Connor J., Antel J. P. Proton magnetic resonance spectroscopic imaging for metabolic characterization of demyelinating plaques. Ann Neurol. 1992 Mar;31(3):235–241. doi: 10.1002/ana.410310302. [DOI] [PubMed] [Google Scholar]
- Arnold D. L., Matthews P. M., Francis G., Antel J. Proton magnetic resonance spectroscopy of human brain in vivo in the evaluation of multiple sclerosis: assessment of the load of disease. Magn Reson Med. 1990 Apr;14(1):154–159. doi: 10.1002/mrm.1910140115. [DOI] [PubMed] [Google Scholar]
- Barker P. B., Gillard J. H., van Zijl P. C., Soher B. J., Hanley D. F., Agildere A. M., Oppenheimer S. M., Bryan R. N. Acute stroke: evaluation with serial proton MR spectroscopic imaging. Radiology. 1994 Sep;192(3):723–732. doi: 10.1148/radiology.192.3.8058940. [DOI] [PubMed] [Google Scholar]
- Barker P. B., Lee R. R., McArthur J. C. AIDS dementia complex: evaluation with proton MR spectroscopic imaging. Radiology. 1995 Apr;195(1):58–64. doi: 10.1148/radiology.195.1.7892496. [DOI] [PubMed] [Google Scholar]
- Birken D. L., Oldendorf W. H. N-acetyl-L-aspartic acid: a literature review of a compound prominent in 1H-NMR spectroscopic studies of brain. Neurosci Biobehav Rev. 1989 Spring;13(1):23–31. doi: 10.1016/s0149-7634(89)80048-x. [DOI] [PubMed] [Google Scholar]
- Blin J., Baron J. C., Dubois B., Pillon B., Cambon H., Cambier J., Agid Y. Positron emission tomography study in progressive supranuclear palsy. Brain hypometabolic pattern and clinicometabolic correlations. Arch Neurol. 1990 Jul;47(7):747–752. doi: 10.1001/archneur.1990.00530070035009. [DOI] [PubMed] [Google Scholar]
- Brenner R. E., Munro P. M., Williams S. C., Bell J. D., Barker G. J., Hawkins C. P., Landon D. N., McDonald W. I. The proton NMR spectrum in acute EAE: the significance of the change in the Cho:Cr ratio. Magn Reson Med. 1993 Jun;29(6):737–745. doi: 10.1002/mrm.1910290605. [DOI] [PubMed] [Google Scholar]
- Bruhn H., Kruse B., Korenke G. C., Hanefeld F., Hänicke W., Merboldt K. D., Frahm J. Proton NMR spectroscopy of cerebral metabolic alterations in infantile peroxisomal disorders. J Comput Assist Tomogr. 1992 May-Jun;16(3):335–344. doi: 10.1097/00004728-199205000-00001. [DOI] [PubMed] [Google Scholar]
- De Stefano N., Matthews P. M., Antel J. P., Preul M., Francis G., Arnold D. L. Chemical pathology of acute demyelinating lesions and its correlation with disability. Ann Neurol. 1995 Dec;38(6):901–909. doi: 10.1002/ana.410380610. [DOI] [PubMed] [Google Scholar]
- Detre J. A., Wang Z. Y., Bogdan A. R., Gusnard D. A., Bay C. A., Bingham P. M., Zimmerman R. A. Regional variation in brain lactate in Leigh syndrome by localized 1H magnetic resonance spectroscopy. Ann Neurol. 1991 Feb;29(2):218–221. doi: 10.1002/ana.410290219. [DOI] [PubMed] [Google Scholar]
- Duyn J. H., Gillen J., Sobering G., van Zijl P. C., Moonen C. T. Multisection proton MR spectroscopic imaging of the brain. Radiology. 1993 Jul;188(1):277–282. doi: 10.1148/radiology.188.1.8511313. [DOI] [PubMed] [Google Scholar]
- Fulham M. J., Bizzi A., Dietz M. J., Shih H. H., Raman R., Sobering G. S., Frank J. A., Dwyer A. J., Alger J. R., Di Chiro G. Mapping of brain tumor metabolites with proton MR spectroscopic imaging: clinical relevance. Radiology. 1992 Dec;185(3):675–686. doi: 10.1148/radiology.185.3.1438744. [DOI] [PubMed] [Google Scholar]
- Gill S. S., Thomas D. G., Van Bruggen N., Gadian D. G., Peden C. J., Bell J. D., Cox I. J., Menon D. K., Iles R. A., Bryant D. J. Proton MR spectroscopy of intracranial tumours: in vivo and in vitro studies. J Comput Assist Tomogr. 1990 Jul-Aug;14(4):497–504. doi: 10.1097/00004728-199007000-00001. [DOI] [PubMed] [Google Scholar]
- Grodd W., Krägeloh-Mann I., Klose U., Sauter R. Metabolic and destructive brain disorders in children: findings with localized proton MR spectroscopy. Radiology. 1991 Oct;181(1):173–181. doi: 10.1148/radiology.181.1.1887030. [DOI] [PubMed] [Google Scholar]
- Grodd W., Krägeloh-Mann I., Petersen D., Trefz F. K., Harzer K. In vivo assessment of N-acetylaspartate in brain in spongy degeneration (Canavan's disease) by proton spectroscopy. Lancet. 1990 Aug 18;336(8712):437–438. doi: 10.1016/0140-6736(90)91982-g. [DOI] [PubMed] [Google Scholar]
- Hahn F. J., Rim K. Frontal ventricular dimensions on normal computed tomography. AJR Am J Roentgenol. 1976 Mar;126(3):593–596. doi: 10.2214/ajr.126.3.593. [DOI] [PubMed] [Google Scholar]
- Higgins J. J., Patterson M. C., Dambrosia J. M., Pikus A. T., Pentchev P. G., Sato S., Brady R. O., Barton N. W. A clinical staging classification for type C Niemann-Pick disease. Neurology. 1992 Dec;42(12):2286–2290. doi: 10.1212/wnl.42.12.2286. [DOI] [PubMed] [Google Scholar]
- Kruse B., Barker P. B., van Zijl P. C., Duyn J. H., Moonen C. T., Moser H. W. Multislice proton magnetic resonance spectroscopic imaging in X-linked adrenoleukodystrophy. Ann Neurol. 1994 Oct;36(4):595–608. doi: 10.1002/ana.410360408. [DOI] [PubMed] [Google Scholar]
- Krägeloh-Mann I., Grodd W., Niemann G., Haas G., Ruitenbeek W. Assessment and therapy monitoring of Leigh disease by MRI and proton spectroscopy. Pediatr Neurol. 1992 Jan-Feb;8(1):60–64. doi: 10.1016/0887-8994(92)90055-4. [DOI] [PubMed] [Google Scholar]
- Larsson H. B., Christiansen P., Jensen M., Frederiksen J., Heltberg A., Olesen J., Henriksen O. Localized in vivo proton spectroscopy in the brain of patients with multiple sclerosis. Magn Reson Med. 1991 Nov;22(1):23–31. doi: 10.1002/mrm.1910220104. [DOI] [PubMed] [Google Scholar]
- Marks H. G., Caro P. A., Wang Z. Y., Detre J. A., Bogdan A. R., Gusnard D. A., Zimmerman R. A. Use of computed tomography, magnetic resonance imaging, and localized 1H magnetic resonance spectroscopy in Canavan's disease: a case report. Ann Neurol. 1991 Jul;30(1):106–110. doi: 10.1002/ana.410300120. [DOI] [PubMed] [Google Scholar]
- Miller B. L. A review of chemical issues in 1H NMR spectroscopy: N-acetyl-L-aspartate, creatine and choline. NMR Biomed. 1991 Apr;4(2):47–52. doi: 10.1002/nbm.1940040203. [DOI] [PubMed] [Google Scholar]
- Miller B. L., Chang L., Booth R., Ernst T., Cornford M., Nikas D., McBride D., Jenden D. J. In vivo 1H MRS choline: correlation with in vitro chemistry/histology. Life Sci. 1996;58(22):1929–1935. doi: 10.1016/0024-3205(96)00182-8. [DOI] [PubMed] [Google Scholar]
- Moffett J. R., Namboodiri M. A., Cangro C. B., Neale J. H. Immunohistochemical localization of N-acetylaspartate in rat brain. Neuroreport. 1991 Mar;2(3):131–134. doi: 10.1097/00001756-199103000-00005. [DOI] [PubMed] [Google Scholar]
- Moffett J. R., Namboodiri M. A., Neale J. H. Enhanced carbodiimide fixation for immunohistochemistry: application to the comparative distributions of N-acetylaspartylglutamate and N-acetylaspartate immunoreactivities in rat brain. J Histochem Cytochem. 1993 Apr;41(4):559–570. doi: 10.1177/41.4.8450195. [DOI] [PubMed] [Google Scholar]
- Negendank W. Studies of human tumors by MRS: a review. NMR Biomed. 1992 Sep-Oct;5(5):303–324. doi: 10.1002/nbm.1940050518. [DOI] [PubMed] [Google Scholar]
- Palmeri S., Battisti C., Federico A., Guazzi G. C. Hypoplasia of the corpus callosum in Niemann-Pick type C disease. Neuroradiology. 1994;36(1):20–22. doi: 10.1007/BF00599187. [DOI] [PubMed] [Google Scholar]
- Peeling J., Sutherland G. High-resolution 1H NMR spectroscopy studies of extracts of human cerebral neoplasms. Magn Reson Med. 1992 Mar;24(1):123–136. doi: 10.1002/mrm.1910240113. [DOI] [PubMed] [Google Scholar]
- Petroff O. A., Pleban L. A., Spencer D. D. Symbiosis between in vivo and in vitro NMR spectroscopy: the creatine, N-acetylaspartate, glutamate, and GABA content of the epileptic human brain. Magn Reson Imaging. 1995;13(8):1197–1211. doi: 10.1016/0730-725x(95)02033-p. [DOI] [PubMed] [Google Scholar]
- Rango M., Spagnoli D., Tomei G., Bamonti F., Scarlato G., Zetta L. Central nervous system trans-synaptic effects of acute axonal injury: a 1H magnetic resonance spectroscopy study. Magn Reson Med. 1995 May;33(5):595–600. doi: 10.1002/mrm.1910330503. [DOI] [PubMed] [Google Scholar]
- Sokol J., Blanchette-Mackie J., Kruth H. S., Dwyer N. K., Amende L. M., Butler J. D., Robinson E., Patel S., Brady R. O., Comly M. E. Type C Niemann-Pick disease. Lysosomal accumulation and defective intracellular mobilization of low density lipoprotein cholesterol. J Biol Chem. 1988 Mar 5;263(7):3411–3417. [PubMed] [Google Scholar]
- Suzuki K., Parker C. C., Pentchev P. G., Katz D., Ghetti B., D'Agostino A. N., Carstea E. D. Neurofibrillary tangles in Niemann-Pick disease type C. Acta Neuropathol. 1995;89(3):227–238. doi: 10.1007/BF00309338. [DOI] [PubMed] [Google Scholar]
- Sylvain M., Arnold D. L., Scriver C. R., Schreiber R., Shevell M. I. Magnetic resonance spectroscopy in Niemann-Pick disease type C: correlation with diagnosis and clinical response to cholestyramine and lovastatin. Pediatr Neurol. 1994 May;10(3):228–232. doi: 10.1016/0887-8994(94)90028-0. [DOI] [PubMed] [Google Scholar]
- Tedeschi G., Bertolino A., Lundbom N., Bonavita S., Patronas N. J., Duyn J. H., Metman L. V., Chase T. N., Di Chiro G. Cortical and subcortical chemical pathology in Alzheimer's disease as assessed by multislice proton magnetic resonance spectroscopic imaging. Neurology. 1996 Sep;47(3):696–704. doi: 10.1212/wnl.47.3.696. [DOI] [PubMed] [Google Scholar]
- Tedeschi G., Bertolino A., Massaquoi S. G., Campbell G., Patronas N. J., Bonavita S., Barnett A. S., Alger J. R., Hallett M. Proton magnetic resonance spectroscopic imaging in patients with cerebellar degeneration. Ann Neurol. 1996 Jan;39(1):71–78. doi: 10.1002/ana.410390111. [DOI] [PubMed] [Google Scholar]
- Tedeschi G., Schiffmann R., Barton N. W., Shih H. H., Gospe S. M., Jr, Brady R. O., Alger J. R., Di Chiro G. Proton magnetic resonance spectroscopic imaging in childhood ataxia with diffuse central nervous system hypomyelination. Neurology. 1995 Aug;45(8):1526–1532. doi: 10.1212/wnl.45.8.1526. [DOI] [PubMed] [Google Scholar]
- Tzika A. A., Ball W. S., Jr, Vigneron D. B., Dunn R. S., Kirks D. R. Clinical proton MR spectroscopy of neurodegenerative disease in childhood. AJNR Am J Neuroradiol. 1993 Nov-Dec;14(6):1267–1284. [PMC free article] [PubMed] [Google Scholar]
- Tzika A. A., Ball W. S., Jr, Vigneron D. B., Dunn R. S., Nelson S. J., Kirks D. R. Childhood adrenoleukodystrophy: assessment with proton MR spectroscopy. Radiology. 1993 Nov;189(2):467–480. doi: 10.1148/radiology.189.2.8210375. [DOI] [PubMed] [Google Scholar]
- Urenjak J., Williams S. R., Gadian D. G., Noble M. Proton nuclear magnetic resonance spectroscopy unambiguously identifies different neural cell types. J Neurosci. 1993 Mar;13(3):981–989. doi: 10.1523/JNEUROSCI.13-03-00981.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vanier M. T., Wenger D. A., Comly M. E., Rousson R., Brady R. O., Pentchev P. G. Niemann-Pick disease group C: clinical variability and diagnosis based on defective cholesterol esterification. A collaborative study on 70 patients. Clin Genet. 1988 May;33(5):331–348. doi: 10.1111/j.1399-0004.1988.tb03460.x. [DOI] [PubMed] [Google Scholar]
- Vion-Dury J., Nicoli F., Salvan A. M., Confort-Gouny S., Dhiver C., Cozzone P. J. Reversal of brain metabolic alterations with zidovudine detected by proton localised magnetic resonance spectroscopy. Lancet. 1995 Jan 7;345(8941):60–61. doi: 10.1016/s0140-6736(95)91184-7. [DOI] [PubMed] [Google Scholar]
- van der Knaap M. S., van der Grond J., Luyten P. R., den Hollander J. A., Nauta J. J., Valk J. 1H and 31P magnetic resonance spectroscopy of the brain in degenerative cerebral disorders. Ann Neurol. 1992 Feb;31(2):202–211. doi: 10.1002/ana.410310211. [DOI] [PubMed] [Google Scholar]