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Regional metabolic patterns in mild cognitive impairment and Alzheimer's disease: A 1H MRS study

K Kantarci1, C R Jack, Y C Xu

  • 1Departments of Diagnostic Radiology, Mayo Clinic, Rochester, MN, USA.

Neurology
|July 26, 2000
PubMed
Abstract

Insights

Proton MR spectroscopic (1H MRS) analysis reveals that elevated myoinositol/creatine (MI/Cr) ratios mark the initial stage of Alzheimer's disease (AD) progression, preceding decreases in N-acetylaspartate/creatine (NAA/Cr) and increases in choline/creatine (Cho/Cr).

Area of Science:

  • Neuroimaging
  • Biomarkers
  • Alzheimer's Disease Research

Background:

  • Mild cognitive impairment (MCI) represents a transitional stage between normal aging and Alzheimer's Disease (AD).
  • Proton magnetic resonance spectroscopic (1H MRS) imaging offers a method to study biochemical changes in vivo.
  • This study investigates 1H MRS alterations in relation to AD pathology progression.

Purpose of the Study:

  • To characterize the temporal sequence of 1H MRS changes in the brains of patients with MCI and AD.
  • To correlate 1H MRS findings with known neurofibrillary pathology stages in AD.
  • To differentiate early AD-related biochemical alterations from those in later stages.

Main Methods:

  • Comparison of 1H MRS findings in the superior temporal lobe, posterior cingulate, and medial occipital lobes.
  • Inclusion of 21 MCI patients, 21 probable AD patients, and 63 elderly controls.
  • Analysis of metabolite ratios including N-acetylaspartate/creatine (NAA/Cr), myoinositol/creatine (MI/Cr), and choline/creatine (Cho/Cr).

Main Results:

  • Significantly lower NAA/Cr ratios were observed in AD patients compared to MCI and controls in specific brain regions.
  • Myoinositol/creatine (MI/Cr) ratios were elevated in both MCI and AD patients compared to controls in the posterior cingulate.
  • Choline/creatine (Cho/Cr) ratios were higher in AD patients than in MCI and control subjects in the posterior cingulate.

Conclusions:

  • The initial 1H MRS alteration in AD progression is an increase in MI/Cr.
  • Decreased NAA/Cr and increased Cho/Cr are indicative of later stages in the AD disease course.
  • 1H MRS can provide insights into the biochemical trajectory of AD.

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