Objective: To determine the significance of ³¹P-MRSI to differentiate between idiopathic Parkinson’s disease (PD), Progressive supranuclear palsy (PSP), and healthy control subjects.

Background: Bioenergetic disturbances, mainly caused by mitochondrial dysfunction, are a well-known pathophysiological concept in neurodegenerative movement disorders. The in-vivo assessment of the brain energy metabolism by ³¹Phosphorus Magnetic Resonance Spectroscopy Imaging (³¹P-MRSI) could serve as a non-invasive neuroimaging method in the differential diagnosis of Parkinsonian disorders.

Method: A total of 30 PD patients, 16 PSP patients, and 25 healthy control subjects underwent a clinical examination, structural magnetic resonance imaging, and ³¹P-MRSI of the forebrain and basal ganglia.

Results: High-energy phosphate metabolites were decreased in PD which was not confounded by differences of the brain structure or demographic data. The reduced high-energy phosphates in the basal ganglia could be used to discriminate PD from PSP with high accuracy (area under the receiver operating characteristics curve of up to 0.93).

Conclusion: Our study suggests that ³¹P-MRSI could serve as an accompanying diagnostic biomarker in the neuroimaging-guided differential diagnosis of Parkinsonian disorders. Further, our results point towards a specific contribution of mitochondrial dysfunction to the development of PD but not PSP.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/reduced-cerebral-energy-metabolism-in-parkinsons-disease-in-contrast-to-progressive-supranuclear-palsy/