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Using proton magnetic resonance spectroscopy to identify mild cognitive impairment

Published online by Cambridge University Press:  16 June 2011

Tao Wang ,
Shifu Xiao ,
Xia Li ,
Bei Ding ,
Huawei Ling ,
Kemin Chen  and
Yiru Fang
Tao Wang
Affiliation:
Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine and Alzheimer's Disease and Related Disorders Center, Shanghai Jiaotong University, Shanghai, China
Shifu Xiao*
Affiliation:
Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine and Alzheimer's Disease and Related Disorders Center, Shanghai Jiaotong University, Shanghai, China
Xia Li
Affiliation:
Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine and Alzheimer's Disease and Related Disorders Center, Shanghai Jiaotong University, Shanghai, China
Bei Ding
Affiliation:
Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Huawei Ling
Affiliation:
Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Kemin Chen
Affiliation:
Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Yiru Fang*
Affiliation:
Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine and Alzheimer's Disease and Related Disorders Center, Shanghai Jiaotong University, Shanghai, China
*
Correspondence should be addressed to: Shifu Xiao, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine; Alzheimer's Disease and Related Disorders Center, Shanghai Jiaotong University. 600 South Wan Ping Road, Shanghai 200030, China. Phone: +86 21 34289888; Fax: +86 21 64387986. Email: [email protected].
Co-correspondent: Yiru Fang, 600 South Wan Ping Road, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China. Email: [email protected].
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Abstract

Background: Single-volume proton magnetic resonance spectroscopy (1H MRS) has considerable diagnostic potential for Alzheimer's disease (AD). This study investigated 1H MRS in specific regions of the brain, the posterior cingulate gyri (PCG) and the hippocampus, in patients with AD, amnestic mild cognitive impairment (aMCI), and in normal control subjects.

Methods:1H MRS analysis was carried out on 47 patients with AD, 32 patients with aMCI and 56 normal control subjects (NC group). Volumes of the PCG and hippocampus were assessed, and the metabolic signals of N-acetylaspartate (NAA), choline compounds (Cho), myo-inositol (mI), and creatine (Cr) were quantified.

Results: In the PCG, differences between the test groups were found in NAA/Cr, Cho/Cr, mI/Cr and NAA/mI ratios. Group differences were also found in mI/Cr and NAA/mI ratios in the left hippocampus, and in mI/Cr and NAA/mI ratios in the right hippocampus. NAA/Cr ratios increased in the PCG between AD and aMCI patients, and between aMCI and NC patients. Conversely, mI/Cr ratios in the PCG and left hippocampus decreased across AD, aMCI, and NC subjects. In discriminate and ROC (Receiver Operating Characteristic) analyses, a NAA/Cr ratio of ≤ 1.50 in the PCG indicated optimal potential for discriminating between aMCI patients and normal control subjects. Discriminating potential was also found to be high for a NAA/mI ratio in the PCG of ≤ 2.72. Despite significant differences between NC and aMCI patients in the mI/Cr ratio in the PCG and in the NAA/mI ratio in the left hippocampus, their sensitivity and specificity were all lower than 75%.

Conclusion: Proton MRS of the PCG using the NAA/Cr ratio as a metabolic marker indicates considerable potential for distinguishing between aMCI and NC subjects.

Keywords

Alzheimer's diseaseNAA/Crposterior cingulate gyrihippocampus
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 1 , January 2012 , pp. 19 - 27
Copyright
Copyright © International Psychogeriatric Association 2011

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References

Ackl, N., Ising, M., Schreiber, Y. A., Atiya, M., Sonntag, A. and Auer, D. P. (2005). Hippocampal metabolic abnormalities in mild cognitive impairment and Alzheimer's disease. Neuroscience Letters, 384, 23–28.CrossRefGoogle ScholarPubMed
Adalsteinsson, E., Sullivan, E. V., Kleinhans, N., Spielman, D. M. and Pfefferbaum, A. (2000). Longitudinal decline of the neuronal marker N-acetyl aspartate in Alzheimer's disease. Lancet, 355, 1696–1697.CrossRefGoogle ScholarPubMed
Catani, M. et al. (2001). (1)H-MR spectroscopy differentiates mild cognitive impairment from normal brain aging. NeuroReport, 12, 2315–2317.CrossRefGoogle ScholarPubMed
Chantal, S., Braun, C. M., Bouchard, R. W., Labelle, M. and Boulanger, Y. (2004). Similar 1H magnetic resonance spectroscopic metabolic pattern in the medial temporal lobes of patients with mild cognitive impairment and Alzheimer disease. Brain Research, 1003, 26–35.CrossRefGoogle ScholarPubMed
Chao, L. L. et al. (2005). Reduced medial temporal lobe N-acetylaspartate in cognitively impaired but nondemented patients. Neurology, 64, 282–289.CrossRefGoogle ScholarPubMed
Choo, I. H. et al. (2010). Posterior cingulate cortex atrophy and regional cingulum disruption in mild cognitive impairment and Alzheimer's disease. Neurobiology of Aging, 31, 772–779.CrossRefGoogle ScholarPubMed
Fayed, N., Dávila, J., Oliveros, A., Castillo, J. and Medrano, J. J. (2008). Utility of different MR modalities in mild cognitive impairment and its use as a predictor of conversion to probable dementia. Academic Radiology, 15, 1089–1098.CrossRefGoogle ScholarPubMed
Fernandez, A. et al. (2005). Proton magnetic resonance spectroscopy and magnetoencephalographic estimation of delta dipole density: a combination of techniques that may contribute to the diagnosis of Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 20, 169–177.CrossRefGoogle Scholar
Godbolt, A. K. et al. (2006). MRS shows abnormalities before symptoms in familial Alzheimer disease. Neurology, 66, 718–722.CrossRefGoogle ScholarPubMed
Huang, W. et al. (2001). Brain metabolite concentration and dementia severity in Alzheimer's disease: a (1)H MRS study. Neurology, 57, 626–632.CrossRefGoogle ScholarPubMed
Jessen, F. et al. (2001). Decrease of N-acetylaspartate in the MTL correlates with cognitive decline of AD patients. Neurology, 57, 930–932.CrossRefGoogle ScholarPubMed
Jessen, F. et al. (2009). A multicenter (1)H-MRS study of the medial temporal lobe in AD and MCI. Neurology, 72, 1735–1740.CrossRefGoogle ScholarPubMed
Kantarci, K. et al. (2002). Comparative diagnostic utility of different MR modalities in mild cognitive impairment and Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 14, 198–207.CrossRefGoogle ScholarPubMed
Kantarci, K. et al. (2004). 1H MR spectroscopy in common dementias. Neurology, 63, 1393–1398.CrossRefGoogle ScholarPubMed
Kantarci, K. et al. (2009). Risk of dementia in MCI: combined effect of cerebrovascular disease, volumetric MRI, and 1H MRS. Neurology, 72, 1519–1525.CrossRefGoogle Scholar
Katzman, R. et al. (1988). A Chinese version of the Mini-Mental State Examination: impact of illiteracy in a Shanghai dementia survey. Journal of Clinical Epidemiology, 41, 971–978.CrossRefGoogle Scholar
Krishnan, K. R. et al. (2003). Randomized, placebo-controlled trial of the effects of donepezil on neuronal markers and hippocampal volumes in Alzheimer's disease. American Journal of Psychiatry, 160, 2003–2011.CrossRefGoogle ScholarPubMed
Martinez-Bisbal, M. C., Arana, E., Marti-Bonmati, L., Mollá, E. and Celda, B. (2004). Cognitive impairment: classification by 1H magnetic resonance spectroscopy. European Journal of Neurology, 11, 187–193.CrossRefGoogle ScholarPubMed
Metastasio, A. et al. (2006). Conversion of MCI to dementia: role of proton magnetic resonance spectroscopy. Neurobiology of Aging, 27, 926–932.CrossRefGoogle ScholarPubMed
Modrego, P. J., Fayed, N. and Pina, M. A. (2005). Conversion from mild cognitive impairment to probable Alzheimer's disease predicted by brain magnetic resonance spectroscopy. American Journal of Psychiatry, 162, 667–675.CrossRefGoogle ScholarPubMed
Nestor, P. J., Fryer, T. D., Smielewski, P. and Hodges, J. R. (2003). Limbic hypometabolism in Alzheimer's disease and mild cognitive impairment. Annals of Neurology, 4, 343–351.CrossRefGoogle Scholar
Pengas, G., Hodges, J. R., Watson, P. and Nestor, P. J. (2010). Focal posterior cingulate atrophy in incipient Alzheimer's disease. Neurobiology of Aging, 31, 25–33.CrossRefGoogle ScholarPubMed
Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183–194.CrossRefGoogle ScholarPubMed
Petersen, R. C. et al. (2001). Current concepts in mild cognitive impairment. Archives of Neurology, 58, 1985–1992.CrossRefGoogle ScholarPubMed
Petersen, R. C. et al. (2010). Alzheimer's Disease Neuroimaging Initiative (ADNI): clinical characterization. Neurology, 74, 201–209.CrossRefGoogle Scholar
Simmons, A., Smail, M., Moore, E. and Williams, S. C. (1998). Serial precision of metabolite peak area ratios and water referenced metabolite peak areas in proton MR spectroscopy of the human brain. Magnetic Resonance Imaging, 16, 319–330.CrossRefGoogle ScholarPubMed
Schuff, N. et al. (2002). Selective reduction of N-acetylaspartate in medial temporal and parietal lobes in AD. Neurology, 58, 928–935.CrossRefGoogle ScholarPubMed
Zhu, X. et al. (2006). Effects of Alzheimer disease on fronto-parietal brain N- acetyl aspartate and myo-inositol using magnetic resonance spectroscopic imaging. Alzheimer Disease and Associated Disorders, 20, 77–85.CrossRefGoogle Scholar