Cognitive impairment:: classification by 1H magnetic resonance spectroscopy
Cognitive impairment:: classification by 1H magnetic resonance spectroscopy
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DOI：
10.1046/j.1468-1331.2003.00746.x
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发表时间：
2004-03-01
影响因子：
5.1
通讯作者：
Celda, B
中科院分区：
文献类型：
--
作者：
Martínez-Bisbal, MC;Arana, E;Celda, B
H-1磁共振波谱（MRS）允许准确和非侵入性的体内代谢研究，是诊断不同形式痴呆的有用工具。认知障碍病理学几乎完全使用MRS进行研究，与健康人进行比较，而没有对阿尔茨海默病（AD）、血管性痴呆、轻度认知障碍（MCI）和伴有认知障碍的重度抑郁症患者进行全球比较。H-1 MRS显示AD患者不同脑区N-乙酰天冬氨酸（NAA）减少和肌肌醇（mI）增加是AD的共同特征，胆碱（Cho）的改变尚无定论。在我们的研究中，64例认知功能障碍患者进行了评估H-1 MRS使用两个回波时间（31和136毫秒）。在扣带回后部，痴呆（AD和血管性痴呆）与非痴呆（MCI和抑郁症）之间的频谱差异有统计学意义。Cho/Cr、mI/Cr和NAA/Cr对不同认知功能障碍的鉴别诊断有重要价值。NAA/mI为诊断AD的最佳ROC曲线下面积，其敏感性（82.5%）和特异性（72.7%）最高。NAA/mI和mI/Cr比值在四种认知障碍退行性病变中不同。在认知障碍实体患者中发现的代谢MRS差异可用于区分AD、血管性痴呆、MCI和抑郁症。
H-1 magnetic resonance spectroscopy (MRS) allows accurate and non-invasive in vivo metabolic study, and is a useful tool for the diagnosis of different forms of dementias. Cognitive impairment pathologies have been almost exclusively studied with MRS by comparison with healthy without a global comparison amongst Alzheimer disease (AD), vascular dementia, mild cognitive impairment (MCI) and major depression patients with cognitive impairment. Whereas decrease of N-acetylaspartate (NAA) and increase myo-Inositol (mI) at different brain locations by H-1 MRS are common features of AD, Choline (Cho) alterations have been inconclusive. In our study, 64 patients with cognitive impairment were evaluated by H-1 MRS using two echo times (31 and 136 ms). There were statistical differences between dementia (AD and vascular dementia) and non-dementia (MCI and depression) spectra at posterior cingulate gyrus. Cho/Cr, mI/Cr and NAA/Cr have been valuables for the differentiation amongst the different cognitive impairment entities. NAA/mI provides the best area under the ROC curve with the highest sensitivity (82.5%) and specificity (72.7%) in diagnosing AD. NAA/mI and mI/Cr ratios differed amongst the four cognitive impairment degenerative pathologies. Metabolic MRS differences found amongst patients with cognitive impairment entities can be useful to differentiate between AD, vascular dementia, MCI and depression.