Quantification of neurometabolites in subacute sclerosing panencephalitis by ¹ H-MRS

Abstract

The authors studied 20 patients with subacute sclerosing panencephalitis (SSPE) to investigate the correlations between MRI, magnetic resonance spectroscopy (MRS), and clinical status. MRI findings did not correlate with clinical status. By contrast, all patients had reductions in N-acetyl aspartate (NAA) and increase in myoinositol (mI) (p < 0.01), and NAA and mI concentrations correlated with clinical severity (p < 0.05). During follow-up, NAA continued to decline. (1)H-MRS may be a useful measure of disease severity and progression in SSPE.

Correlation of Quantitative Diffusion Tensor Tractography with Clinical Grades of Subacute Sclerosing Panencephalitis

“…5,6 Patients with severe disease may still have normal findings on conventional MR imaging examinations. 9 On a single-voxel proton MR spectroscopic study, Aydin et al 9 have shown a significant correlation between clinical severity and N-acetylaspartate and myo-inositol in the frontal white matter of patients with SSPE. However, the localized spectroscopic approach does not reflect the degree of damage in the entire brain.…”

“…7 Metabolite abnormalities in the normal-appearing white matter of patients with SSPE have been described on in vivo proton MR spectroscopy. 1,8 Aydin et al 9 have shown significant correlation between clinical severity and absolute concentration of N-acetylaspartate and myo-inositol in the frontal white matter of patients with SSPE. Diffusion-weighted imaging studies have reported increased apparent diffusion coefficient values in normal-appearing white matter on MR imaging in patients with SSPE compared with controls.…”

Blue Moon Neurovirology: The Merits of Studying Rare CNS Diseases of Viral Origin

“…Importantly, infectious MV cannot be recovered from SSPE tissues, implicating cellular or viral changes that affect the viral life cycle. While MV RNA is present in SSPE brains, the mechanism for SSPE pathogenesis is unknown, though SSPE is marked by neurodegeneration, astrogliosis, and markers for oxidative stress in the brain (Aydin et al 2006). Treatments such as ribavirin and interferon have produced conflicting results in SSPE patients, and there is currently no standard treatment protocol for SSPE other than supportive care.…”

Reduced Gray Matter Volume in the Frontotemporal Cortex of Patients with Early Subacute Sclerosing Panencephalitis

“…Several quantitative imaging studies with a region-of-interest design such as quantitative diffusion MR imaging and proton MR spectroscopy 8,9,17 have been conducted to investigate the in vivo neuropathologic findings in patients with early SSPE. Because conventional imaging findings usually appear normal in early SSPE, quantitative imaging studies investigating patients with early SSPE require a prior hypothesis of localization.…”

“…However, recent MR spectroscopy studies have demonstrated that the metabolic alterations caused by neuronal loss and gliosis were present even in normalappearing cerebral tissue in the initial stages of SSPE. 8,9 Voxelbased morphometry is an automated statistical image-analysis method that is used to search gray matter volume differences between various subject groups. 10 Voxel-based morphometry can detect minor morphologic changes that could not be detected by visual case analyses.…”