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MRI Spectroscopy Does Not Detect Early Parkinsonís

Doctors have long been searching for supplementary tests to help diagnose Parkinson’s disease (PD) in its earliest stages. A recent study, published in the December 10, 2013 issue of Neuroimaging, suggests that two types of magnetic resonance imaging (MRI), may be ineffective in diagnosing early PD. The results shed further light on Parkinson’s and will enable researchers to focus their energies on alternative methods of diagnosing the disease.

The researchers tested two types of MRIs known as spectroscopic imaging. Both types (similar to conventional MRI) use strong magnetic fields and waves to take pictures of the brain. However, in contrast to conventional MRI, these types of imaging can reveal the presence of certain natural chemicals in the brain that are involved in energy production. Scientists have theorized that because of this capability, the scans might be useful in detecting chemical changes in PD that conventional MRI is unable to see. 

In the new study, researchers led by Nora Weiduschat, M.D., at the Parkinson’s Disease Foundation (PDF) Research Center of Weill Cornell Medical College, used two types of MR spectroscopic imaging to measure the levels of six natural chemicals in the brains of 20 people with early PD and 15 healthy volunteers of similar ages. The people with PD had lived with the disease for, on average, three years. The chemicals the researchers studied have been investigated before with conflicting results – with some studies showing changing levels of these chemicals in the brains of people with PD, but others showing no change. 

Results

  • Scans showed that levels of the six chemicals were not different in people with early PD versus healthy volunteers in any of the brain regions examined.
  • For the people with early PD, there was no correlation between the levels of the brain chemicals and disease duration, age, medication or severity of their Parkinson’s symptoms.

What Does It Mean?

MRI scans are often normal in people with classic Parkinson's, although doctors often use them to rule out other causes of Parkinsonism, such as small blood vessels strokes that lead to vascular Parkinsonism. However, in recent years MRI technology has improved significantly, which is what led scientists to investigate MR spectroscopy for its potential to help in the diagnosis of early PD. 

This study suggests that MR spectroscopic imaging may not be useful for diagnosing early Parkinson’s disease. The scans showed that levels of six chemicals involved in cell energy production did not differ substantially in the brains of people with versus those without PD. 

Given the study’s results and previous conflicting results about these chemicals, it is possible that the levels of chemicals do not change in PD. But it is also possible that in people with early PD, any changes in the six brain chemicals tested may still be too subtle to detect with current technology. One possible way to increase the sensitivity of MR spectroscopic imaging is to stimulate the brain by shining a flickering light in the eyes of the person undergoing the procedure. Brain stimulation requires energy, which may reveal detectable changes in natural brain chemicals between people with and without early PD. This idea must be tested in future research.

Despite the fact that the MRI methods may not be helpful immediately for diagnosis, Dr. Weiduschat’s findings may help researchers focus their resources elsewhere in the search for an early PD detection method.  Early detection PD will be critical in the future, when scientists hopefully reach the goal of developing neuroprotective treatments that could stop or reverse the disease.

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Reference: Weiduschat N, Mao X, Beal MF, Nirenberg MJ, Shungu DC, Henchcliffe C (2013) Usefulness of Proton and Phosphorus MR Spectroscopic Imaging for Early Diagnosis of Parkinson's Disease. J Neuroimaging. e-pub ahead of print. DOI: 10.1111/jon.12074  http://dx.doi.org/10.1111/jon.12074

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Source Date: Jan 13 2014