phosphocreatine and Parkinson-Disease--Secondary

Extrapyramidal side-effects (EPS), the most frequent and severe side-effects of antipsychotics, sometimes become irreversible and cause severe psychosocial disturbance in patients with schizophrenia. However, the neurobiological basis of EPS has not yet been elucidated. In this study, neurochemical correlates of EPS were examined by 1H-MR spectroscopy (1H-MRS). Sixteen medicated patients with schizophrenia and 15 age-, gender- and parental-socioeconomic-status-matched normal controls were examined using single-voxel 1H-MRS. Absolute concentrations of N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine/phosphocreatine, myo-inositol, and Glx (glutamate and glutamine) in the left putamen were evaluated. The patient group showed mild EPS and no significant metabolic abnormalities in this region. The more severe drug-induced parkinsonism assessed by the Simpson-Angus Scale, however, significantly correlated with the higher Cho concentration and tended to be correlated with the higher NAA concentration in the patient group. These results suggest a potential of 1H-MRS as a non-invasive monitoring method of neurobiological correlates of EPS associated with neuroleptic treatments in patients with schizophrenia.

Topics: Adult; Antipsychotic Agents; Aspartic Acid; Basal Ganglia Diseases; Choline; Chronic Disease; Creatine; Dominance, Cerebral; Energy Metabolism; Female; Glutamic Acid; Glutamine; Humans; Inositol; Magnetic Resonance Spectroscopy; Male; Middle Aged; Neurologic Examination; Parkinson Disease, Secondary; Phosphocreatine; Putamen; Reference Values; Schizophrenia; Schizophrenic Psychology

Proton magnetic resonance spectroscopy (1H-MRS), localized to the lentiform nucleus, was carried out in 12 patients with idiopathic Parkinson's disease (IPD), seven patients with multiple-system atrophy (MSA), seven patients with progressive supranuclear palsy (PSP), and 10 healthy age-matched controls. The study assessed the level of N-acetylaspartate (NAA), creatine-phosphocreatine (Cr), and choline (Cho) in the putamen and globus pallidus of these patients. NAA/Cho and NAA/Cr ratios were significantly reduced in MSA and PSP patients. No significant difference was found between IPD patients and controls. These results suggest an NAA deficit, due to neuronal loss, in the lentiform nucleus of MSA and PSP patients. 1H-MRS is a noninvasive technique that can provide useful information regarding striatal neuronal loss in basal ganglia of patients with atypical parkinsonian disorders and represents a potential tool for diagnosing these disorders.

Topics: Aged; Antiparkinson Agents; Aspartic Acid; Atrophy; Cerebral Cortex; Choline; Corpus Striatum; Creatinine; Female; Globus Pallidus; Humans; Levodopa; Magnetic Resonance Spectroscopy; Middle Aged; Parkinson Disease; Parkinson Disease, Secondary; Phosphocreatine; Protons; Putamen; Supranuclear Palsy, Progressive