Brain metabolite concentration and dementia severity in Alzheimer's disease -: A 1H MRS study
Brain metabolite concentration and dementia severity in Alzheimer's disease -: A 1H MRS study
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DOI：
10.1212/wnl.57.4.626
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发表时间：
2001-08-28
期刊：
影响因子：
9.9
通讯作者：
Schapiro, MB
中科院分区：
文献类型：
--
作者：
Huang, W;Alexander, GE;Schapiro, MB
目的：H-1-MRS研究显示AD患者脑内肌醇（mI）和N-乙酰天冬氨酸（NAA）水平异常，但未研究这些异常与痴呆严重程度的关系。作者试图确定轻度AD患者脑内mI和其他代谢物水平是否发生改变，以及它们是否随着痴呆严重程度的增加而改变。研究方法：作者使用H-1-MRS和外部标准测量21例AD受试者和17例年龄和性别匹配的对照者枕叶和左右顶叶区域的mI、NAA、总肌酸（Cr）和含胆碱（Cho）化合物的绝对脑浓度。结果如下：与对照组相比，AD患者所有三个脑区的NAA浓度均显著降低，而mI和Cr浓度均显著升高。即使在轻度AD中，mI和Cr的浓度也较高。判别分析的H-1-MRS数据结合CSF体积测量区分AD受试者，从轻度到重度痴呆，从控制100%正确分类。NAA浓度，而不是其他代谢产物，与简易精神状态检查评分呈正相关。结论：在新皮质中的绝对代谢物浓度的H-1-MRS测量显示AD中的脑代谢物浓度异常;这些代谢物浓度不一定与疾病的严重程度相关。虽然肌醇和肌酸的变化发生在AD的早期阶段，N-乙酰天冬氨酸的异常不发生在轻度AD，但随着痴呆的严重程度进行性变化。此外，患有轻度AD的受试者可以与患有H-1-MRS的对照区分开。
Objective: H-1-MRS studies have shown abnormalities in brain levels of inyo-inositol (mI) and N-acetyl aspartate (NAA) in AD, but the relation of these abnormalities with dementia severity was not examined. The authors sought to determine whether altered brain levels of mI and other metabolites occur in mild AD and whether they change as dementia severity worsens. Methods: The authors used H-1-MRS with external standards to measure absolute brain concentrations of mI, NAA, total creatine (Cr), and choline (Cho)-containing compounds in 21 subjects with AD and 17 age- and sex-matched controls in occipital and left and right parietal regions. Results: Concentrations of NAA were significantly decreased, whereas mI and Cr concentrations were significantly increased in all three brain regions in subjects with AD compared with controls. Higher concentrations of mI and Cr occurred even in mild AD. A discriminant analysis of the H-1-MRS data combined with CSF volume measurements distinguished subjects with AD, ranging from mild to severe dementia, from controls with 100% correct classification. NAA concentration, though not other metabolites, was positively correlated with Mini-Mental State Examination score. Conclusion: The measurements with H-1-MRS of absolute metabolite concentrations in the neocortex showed abnormal concentrations of brain metabolites in AD; these metabolite concentrations do not necessarily correlate with disease severity. Although changes in myo-inositol and creatine occur in the early stages of AD, abnormalities of N-acetyl aspartate do not occur in mild AD but progressively change with dementia severity. Further, subjects with mild AD can be differentiated from controls with H-1-MRS.