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Short TE Quantitative Proton Magnetic Resonance Spectroscopy in Variant Creutzfeldt-Jakob Disease

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Abstract

Variant Creutzfeldt-Jakob disease (vCJD) is a fatal neurodegerative disorder. Clinical diagnosis is difficult in the early stages as the disease often presents with non-specific psychiatric and neurological symptoms. To investigate the diagnostic potential of quantitative short TE in vivo MRS, and the nature and anatomical distribution of biochemical abnormalities in vCJD, localised single-voxel spectra (TE/TR 30 ms/2,000 ms) were acquired from three brain regions: thalami, caudate nuclei and frontal white matter. Metabolite concentrations and ratios from three patients with definite or probable vCJD were compared with eight normal age-matched controls. Abnormal signal on T2-weighted MRI was apparent in the pulvinar region in all vCJD patients; this region also showed greatly increased myo-inositol [MI] (mean 2.5-fold, P=0.01) and decreased N-acetyl-aspartate (NAA; mean 2-fold, P=0.01). Two patients also showed increased [MI] (z=17, 11; one with decreased NAA, z=-12) in normal-appearing caudate nuclei. The magnitude of metabolite abnormalities in the thalami in moderately advanced vCJD suggests a potential role in earlier diagnosis. Short TE protocols allow the measurement of MI, which adds discriminant power to the MRS examination.

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Acknowledgements

The authors would like to acknowledge the assistance of Hilary Watt, statistician at London School for Hygiene and Tropical Medicine, Professor John Collinge in the Prion Unit, University College London, and their colleagues in the Dementia Research Group. This work was supported by the Medical Research Council of Great Britain.

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Authors and Affiliations

  1. Dementia Research Group, Institute of Neurology, University College London, London, UK

    R. J. Cordery, A. Godbolt, M. N. Rossor & A. D. Waldman

  2. Division of Neuroscience and Psychological Medicine, Faculty of Medicine, Imperial College of Science, Technology and Medicine, London, UK

    R. J. Cordery, A. Godbolt, M. N. Rossor & A. D. Waldman

  3. NMR Research Unit, Department of Clinical Neurology,Institute of Neurology, University College London, London, UK

    D. MacManus

  4. Department of Imaging, Charing Cross Hospital, Fulham Palace Road, London, UK

    A. D. Waldman

  5. Dementia Research Group, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK

    A. D. Waldman

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  1. R. J. Cordery
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  2. D. MacManus
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  3. A. Godbolt
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  4. M. N. Rossor
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  5. A. D. Waldman
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Correspondence to A. D. Waldman.

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Cordery, R.J., MacManus, D., Godbolt, A. et al. Short TE Quantitative Proton Magnetic Resonance Spectroscopy in Variant Creutzfeldt-Jakob Disease. Eur Radiol 16, 1692–1698 (2006). https://doi.org/10.1007/s00330-005-0090-4

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  • DOI: https://doi.org/10.1007/s00330-005-0090-4

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