SPECTROSCOPY OF ALZHEIMERS DISEASE & VASCULAR DEMENTIA

该项目的总体目标是使用31-磷（31 P） 和质子（1H）核磁共振（NMR）光谱，如果大脑 代谢标志物的存在，将区分阿尔茨海默病， 与多部位皮质下缺血相关的痴呆。 五 一年的纵向研究将调查临床，成像（磁 共振成像，MRI）、代谢（体内31 P和1H NMR）和 选择的多发性皮质下神经病变患者的神经病理学数据 缺血性痴呆（MSID）、阿尔茨海默病（AD）或混合AD，以及 血管疾病和非痴呆老年对照组。该研究旨在 表征脑能量磷酸盐，磷脂代谢， pH值、游离镁、N-乙酰天冬氨酸和可能 准确预测AD、MSID和混合型AD的临床和病理诊断 MSID/AD。 此外，两个假设将进行测试，以解释转变 朝向磷光谱的高能磷酸盐端， 在MSID中报告。 一种假设将这种转变归因于 在断开的大脑表层区域中利用分子能量 来自皮层下损伤的神经元输入。其他假设属性 皮质区域星形胶质细胞反应性增加的转变， 受到了轻微的局部缺血 第一个假设预测 高能磷酸盐迁移的程度应该与 皮质下白色物质的范围和位置 MRI上观察到高信号。 第二个假设预测MSID 向高能磷酸盐端转移的患者， 磷光谱将有微腔和增加的胶质细胞 在获得光谱的皮质区域中的免疫反应性，甚至 尽管这些区域在核磁共振成像上看起来很正常

The overall aim of this project is to determine, using 31-Phosphorous (31P) and proton (1H) nuclear magnetic resonance (NMR) spectroscopy, if brain metabolic markers exist that will distinguish Alzheimer's disease from dementia associated with multiple sites of subcortical ischemia. A five year longitudinal study will investigate clinical, imaging (magnetic resonance imaging, MRI), metabolic (in vivo 31P and 1H NMR) and neuropathologic data in selected patients with multiple subcortical ischemic dementia (MSID), Alzheimer's disease (AD), or mixed AD and vascular disease. and in nondemented elderly controls. The study aims to characterize changes in brain energy phosphate, phospholipid metabolism, pH, free magnesium, N-acetyl aspartate, and cholinated compounds that might accurately predict clinical and pathologic diagnoses of AD, MSID, and mixed MSID/AD. Further, two hypotheses will be tested to explain the shift towards the high energy phosphate end of the phosphorus spectrum previously reported in MSID. One hypothesis attributes the shift to a decreased utilization of molecular energy in superficial brain regions disconnected from neuronal input by subcortical lesions. The other hypothesis attributes the shift to increased astrocytic reactivity in cortical regions that have been subjected to mild levels of ischemia. The first hypothesis predicts that the extent of the high energy phosphate shift should be correlated with the extent and location of the subcortical white matter hyperintensities observed on MRI. The second hypothesis predicts that MSID patients with a shift towards the high energy phosphate end of the phosphorus spectrum will have microcavities and increased glial immunoreactivity in cortical regions where spectra are obtained, even though these areas appeared to be normal on MRI.