Magnetic resonance spectroscopy and brain volumetry in mild cognitive impairment. A prospective study
Nicolás Fayed1, Pedro J Modrego2, Gracián García-Martí3
1Radiology Department, Quirón Hospital, Zaragoza 50009, Spain.
Objective:
To assess the accuracy of magnetic resonance spectroscopy (1H-MRS) and brain volumetry in mild cognitive impairment (MCI) to predict conversion to probable Alzheimer's disease (AD).
Methods:
Forty-eight patients fulfilling the criteria of amnestic MCI who underwent a conventional magnetic resonance imaging (MRI) followed by MRS, and T1-3D on 1.5 Tesla MR unit. At baseline the patients underwent neuropsychological examination. 1H-MRS of the brain was carried out by exploring the left medial occipital lobe and ventral posterior cingulated cortex (vPCC) using the LCModel software. A high resolution T1-3D sequence was acquired to carry out the volumetric measurement. A cortical and subcortical parcellation strategy was used to obtain the volumes of each area within the brain. The patients were followed up to detect conversion to probable AD.
Results:
After a 3-year follow-up, 15 (31.2%) patients converted to AD. The myo-inositol in the occipital cortex and glutamate+glutamine (Glx) in the posterior cingulate cortex predicted conversion to probable AD at 46.1% sensitivity and 90.6% specificity. The positive predictive value was 66.7%, and the negative predictive value was 80.6%, with an overall cross-validated classification accuracy of 77.8%. The volume of the third ventricle, the total white matter and entorhinal cortex predict conversion to probable AD at 46.7% sensitivity and 90.9% specificity. The positive predictive value was 70%, and the negative predictive value was 78.9%, with an overall cross-validated classification accuracy of 77.1%. Combining volumetric measures in addition to the MRS measures the prediction to probable AD has a 38.5% sensitivity and 87.5% specificity, with a positive predictive value of 55.6%, a negative predictive value of 77.8% and an overall accuracy of 73.3%.
Conclusion:
Either MRS or brain volumetric measures are markers separately of cognitive decline and may serve as a noninvasive tool to monitor cognitive changes and progression to dementia in patients with amnestic MCI, but the results do not support the routine use in the clinical settings.
Insights
Magnetic resonance spectroscopy (MRS) and brain volumetry show promise in predicting Alzheimer's disease (AD) progression in mild cognitive impairment (MCI) patients. While these noninvasive tools aid in monitoring cognitive changes, routine clinical use is not yet supported.
Area of Science:
- Neuroimaging
- Neurology
- Biomarkers
Background:
- Mild cognitive impairment (MCI) is a transitional stage between normal aging and dementia.
- Early prediction of conversion to probable Alzheimer's disease (AD) is crucial for timely intervention.
- Conventional magnetic resonance imaging (MRI) and advanced techniques like magnetic resonance spectroscopy (MRS) offer potential for early detection.
Purpose of the Study:
- To evaluate the accuracy of 1H-MRS and brain volumetry in predicting the conversion of amnestic MCI patients to probable AD.
- To assess the individual and combined predictive power of these neuroimaging techniques.
Main Methods:
- Forty-eight amnestic MCI patients underwent MRI, 1H-MRS (left medial occipital lobe, ventral posterior cingulated cortex), and volumetric measurements.
- Neuropsychological examinations were performed at baseline.
- Patients were followed for 3 years to determine conversion to probable AD.
Main Results:
- After 3 years, 31.2% of patients converted to AD.
- MRS measures (myo-inositol, Glx) and volumetric measures (third ventricle, white matter, entorhinal cortex) independently predicted conversion with accuracies around 77%.
- Combined MRS and volumetric measures showed a slightly lower overall accuracy of 73.3%.
Conclusions:
- Both MRS and brain volumetric measures serve as valuable noninvasive markers for cognitive decline and progression to dementia in amnestic MCI.
- These techniques can aid in monitoring cognitive changes.
- Current evidence does not support their routine use in clinical settings.
More Related Videos
13:56The Use of Magnetic Resonance Spectroscopy as a Tool for the Measurement of Bi-hemispheric Transcranial Electric Stimulation Effects on Primary Motor Cortex Metabolism
Published on: November 19, 2014
10:21Metabolic Support of Excised, Living Brain Tissues During Magnetic Resonance Microscopy Acquisition
Published on: October 18, 2017
Related Concept Videos
01:24Magnetic Resonance Imaging
01:14Brain Imaging
These technologies include computerized axial tomography (CAT or CT scans), positron-emission tomography (PET scans), magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), and Transcranial Magnetic...
01:27Imaging Studies IV: Magnetic Resonance Imaging