Proton magnetic resonance spectroscopy in suspected vascular ischemic parkinsonism.

Up to now the existence of "vascular parkinsonism" has been doubtful because conclusive clinicopathologic studies are lacking. The objective of the present magnetic resonance spectroscopy (MRS) study is to detect metabolic signs as a reflect of ischemic lesions which could be responsible for the clinical features of vascular parkinsonism. Proton MRS of the brain was performed in 12 patients suspected of vascular parkinsonism on clinical grounds and ischemic score, and in a control group of 15 patients with idiopathic Parkinson's disease. The MR spectra were measured in the striatum and deep white matter. MRS did not demonstrate metabolic evidence for the existence of ischemia (elevated lactate) or cell loss (decreased N-acetyl-aspartate levels) in patients suspected of vascular parkinsonism. Several explanations for our findings are discussed.