Abstract:
Subacute sclerosing panencephalitis (SSPE) is a rare,
progressive, inflammatory neurodegenerative disease. Our aim was to determine the metabolic
abnormalities of brain in early- and late-stage SSPE by using MR spectroscopy and to assess
areas of involvement in the early stages when MR imaging findings were normal.
METHODS: Children with stage II (n 3) or III (n 3) SSPE and 10 healthy, age-matched
children underwent MR imaging, multivoxel MR spectroscopy, and short-echo single-voxel MR
spectroscopy (SVS). Areas of involvement in the brain were determined with chemical shift
imaging. For SVS, 2 2 2-cm voxels were placed in the frontal subcortical white matter
(FSWM) and parieto-occipital white matter (POWM). N-acetylaspartate (NAA)/creatine (Cr),
choline (Cho)/Cr, myo-inositol (Ins)/Cr, and NAA/Cho ratios were calculated.
RESULTS: Comparisons of NAA/Cr, Cho/Cr, Ins/Cr and NAA/Cho ratios between patients
and control subjects showed significant differences in FSWM and POWM (P < .01). In patients
with SSPE, NAA/Cr ratios in POWM were significantly less than those in FSWM (P < .01).
NAA/Cr ratios in patients with stage II SSPE and those in the control group were not
significantly different; this may reflect the absence of neuronal loss. Decreased NAA/Cr,
increased Cho/Cr and Ins/Cr ratios, and increased lactate and lipid peaks were found in
patients with stage III SSPE.
CONCLUSION: MR spectroscopy showed findings suggestive of inflammation in stage II and
findings of demyelination, gliosis, cellular necrosis, and anaerobic metabolism in stage III. MR
spectroscopy could be a promising technique for early diagnosis and treatment planning in
cases of SSPE.
