Parkinsonian signs correlate with basal ganglia changes in cirrhosis
patients
WESTPORT, Sep 11, 2000 (Reuters Health) - Magnetic resonance imaging
(MRI) and proton magnetic resonance spectroscopy (MRS) reveal basal
ganglia abnormalities in cirrhotic patients with parkinsonian signs,
according to a report in the September issue of Gastroenterology.
Previous reports of MRI and MRS abnormalities in patients with cirrhosis
have not clearly been linked to neurologic or cognitive impairment, the
authors explain. Moreover, parkinsonian signs have only occasionally
been investigated in patients with hepatic encephalopathy due to
cirrhosis.
Dr. Laurent Spahr and colleagues, from University Hospital, in Geneva,
Switzerland, conducted MRI and MRS studies on 19 patients with
cirrhosis awaiting liver transplants and compared the results with the
patients' parkinsonian signs, as measured by the Unified Parkinson's
Disease Rating Scale (UPDRS) and the Purdue Pegboard test.
On MRI, occipital white matter and all basal ganglia tissue except
thalamus exhibited significant signal hyperintensity in patients with
cirrhosis
and mild hepatic encephalopathy, the authors report.
As previously seen in MRS studies of patients with cirrhosis, the
myoinositol/creatine and choline/creatine ratios were decreased and the
glutamine-glutamate/creatine ratio slightly increased in patients with
mild
hepatic encephalopathy, the investigators note.
In these patients, MRI intensities in the pallidum, caudate, and putamen
correlated positively with UPDRS scores, the report indicates.
Similarly,
there were correlations between MRS findings and either UPDRS scores
or Purdue Pegboard scores. In three patients who were retested after
successful liver transplantations, MRI signal alterations disappeared
and
MRS findings normalized.
The authors conclude that the findings support "the view of clinically
significant basal ganglia alterations in these patients."
Gastroenterology 2000;119:774-781.
Copyright © 2000 Reuters Limited.
--
Judith Richards, London, Ontario, Canada
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