Proton MR spectroscopy of the cerebellum and pons in patients with degenerative ataxia

Radiology. 2002 May;223(2):371-8. doi: 10.1148/radiol.2232010722.


Purpose: To investigate whether proton magnetic resonance (MR) spectroscopy is a useful complement to MR imaging in patients with degenerative ataxia.

Materials and methods: Brain MR imaging and single-voxel proton MR spectroscopy of the right cerebellar hemisphere and pons were performed in 30 patients with sporadic (n = 16) or inherited (n = 14) degenerative ataxia and in 20 healthy control subjects. Several indexes of brainstem and cerebellar atrophy were measured on MR images, as well as the N-acetylaspartate/creatine (NAA/Cr), choline/Cr (Cho/Cr), and myo-inositol/Cr (mI/Cr) ratios in the MR spectra. Differences between patients and subjects were evaluated with the Kruskal-Wallis and Mann-Whitney tests, whereas correlation of clinical, MR imaging, and spectroscopic data was assessed with nonparametric Spearman rank correlation.

Results: Measurements of brainstem and cerebellar atrophy obtained from MR images revealed patients had olivopontocerebellar atrophy (OPCA) (n = 11), spinal atrophy (SA) (n = 8), or corticocerebellar atrophy (CCA) (n = 4). Seven patients did not fulfill the criteria for any group and were considered undefined. In patients with OPCA, the pontine and cerebellar NAA/Cr and Cho/Cr ratios were significantly decreased when compared with those of the control subjects. Pontine and cerebellar NAA/Cr ratios were also significantly reduced in patients with SA and CCA. Five patients with undefined ataxia had a substantial decrease of pontine or cerebellar NAA/Cr ratio when compared with that of the control subjects. In patients with OPCA, the pontine NAA/Cr ratio (but not the atrophy measurements) showed a correlation (P =.04) with disability.

Conclusion: MR spectroscopy is a useful complement to MR imaging in patients with degenerative ataxia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Aspartic Acid / analogs & derivatives*
  • Aspartic Acid / metabolism
  • Ataxia / metabolism
  • Ataxia / pathology*
  • Case-Control Studies
  • Cerebellar Ataxia / metabolism
  • Cerebellar Ataxia / pathology*
  • Choline / metabolism
  • Creatinine / metabolism
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Inositol / metabolism
  • Magnetic Resonance Imaging
  • Magnetic Resonance Spectroscopy*
  • Male
  • Middle Aged
  • Pons / metabolism
  • Pons / pathology*
  • Protons
  • Statistics, Nonparametric


  • Protons
  • Aspartic Acid
  • Inositol
  • N-acetylaspartate
  • Creatinine
  • Choline