Exploration of Differences in Metabolite Concentrations by 7Teslas NMR Spectroscopy in Striatum and Subthalamic Nuclei in de Novo Parkinsonian Patients and Control Subjects

The project presented is an open and controlled exploratory prospective study, assessing metabolic concentrations in putamen and NST left and right of treatment-naïve de novo Parkinsonian patients compared to healthy subjects. Patients will be included consecutively following the screening. Since this study is cross-sectional, a single visit will be made. De novo PD patients will be pre-selected in the departments of Neurology of the CHU of Clermont-Ferrand and Poitiers.

The inclusion visit will be carried out during a consultation during their usual follow-up in the departments of Neurology of the CHU of Clermont-Ferrand and Poitiers.

The following data will be noted: age, sex, level of study, duration of disease progression, ongoing treatments, medical history.

Patients verifying the inclusion and exclusion criteria will be definitively included and their consents will be collected.

De novo PD patients will undergo their NMR examination in the department of radiology, 7T MRI at the Poitiers hospital.

Patients will report to MRI and the following measurements will be performed:

• measurement of motor disorders by the UPDRS scale, the Hoehn and Yahr and Schwab and England score;
• acquisition of NMR images and spectra. The experimental time will be 30 minutes for the UPDRS scale and 30 minutes for the NMR exam.

Recruitment of the subjects in the control group will be carried out in the patients' family and in that of the staff of the departments of neurology and radiology.

They will be matched to de novo PD patients according to age, sex and level of education. In practice, after pre-screening the control subjects, they will be informed about the protocol, their consent will be collected. The following data will also be noted: age, sex, duration and level of study.

After verification of the inclusion and exclusion criteria, the witnesses will take the NMR examination in the Radiological Department, 7T MRI at the Poitiers University Hospital Hospital.

Inclusion criteria

Patients will be included:

• suffering from idiopathic Parkinson's disease according to UKPDSBB criteria (Gibb & Lees, 1988; Hughes et al., 1992),
• the stage of the disease is I-II according to the Hoehn and Yahr scale,
• which do not receive dopaminergic treatment,
• duration of disease development 5 years,
• without major cognitive impairment (Moca > 24)
• men or women aged 18 to 75,
• having understood and signed the informed consent form,
• members of a social security scheme.

Controls:

• subjects male or female aged 18 -75 years
• subjects affiliated to a social security scheme.
• volunteers who have given their written consent.

Exclusion criteria

Patients will be excluded:

• having a severe tremor (> 3 for a trembling sub-item of UPDRS 3) making the MR examination impossible,
• patients with "contra-indications" to an MRI exam (without administration of a gadolinium chelate): presence of metal parts in the body (electronic devices such as a pacemaker, a neurostimulator, a cochlear implant, prostheses, etc.), claustrophobia,
• taking any treatment that may interact with brain concentrations of neurotransmitters, such as all psychotropic drugs and in particular antidepressants, neuroleptics, benzodiazepines, antiepileptics,
• pregnant women,
• treated by deep brain neurostimulation,
• patients under guardianship or guardianship or protection of justice,
• patients who are excluded from another study.

Controls:

• persons suffering from progressive neurological and psychiatric pathology,
• persons with "contra-indications" to an MRI examination (without administration of a gadolinium chelate): presence of metal parts in the body (electronic devices such as a pacemaker, a neurostimulator, a cochlear implant, prostheses, etc.), claustrophobia,
• taking any treatment that may interact with brain concentrations of neurotransmitters, such as: all psychotropic drugs and in particular antidepressants, neuroleptics, benzodiazepines, antiepileptics,
• pregnant women,
• persons under guardianship or trusteeship or protection of justice,
• people who are excluded from another study.