Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Google Scholar
Right arrow Articles by Jessen, F.
Right arrow Articles by Träber, F.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Jessen, F.
Right arrow Articles by Träber, F.
Related Collections
Right arrow MRS
Right arrow Alzheimer's disease
Right arrow MCI (mild cognitive impairment)
NEUROLOGY 2009;72:1735-1740
© 2009 American Academy of Neurology

A multicenter 1H-MRS study of the medial temporal lobe in AD and MCI

F. Jessen, MD, O. Gür, MD, W. Block, PhD, G. Ende, PhD, L. Frölich, MD, T. Hammen, MD, J. Wiltfang, MD, T. Kucinski, MD, H. Jahn, MD, R. Heun, MD, W. Maier, MD, H. Kölsch, PhD, J. Kornhuber, MD and F. Träber, PhD

From the Departments of Psychiatry (F.J., R.H., W.M., H.K.) and Radiology (O.G., W.B., F.T.), University of Bonn; Central Institute of Mental Health (G.E., L.F.), Mannheim; Center Epilepsy Erlangen, Clinics of Neurology (T.H.), and Department of Psychiatry (J.K., J.W.), University Erlangen; Department of Psychiatry (J.W.), University Essen, Germany; Department of Neuroradiology (T.K.), Karolinska University Hospital, Stockholm, Sweden; Department of Psychiatry (H.J.), University Hamburg, Germany; and Department of Psychiatry (R.H.), Division of Neuroscience, University of Birmingham, UK.

Address correspondence and reprint requests to Dr. Frank Jessen, Department of Psychiatry, University of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany Jessen{at}uni-bonn.de

Objective: The need for biological markers of Alzheimer disease (AD) is constantly increasing. Proton magnetic resonance spectroscopy (1H-MRS) studies have provided consistent evidence for a reduction of the neuronal marker N-acetylaspartate (NAA) in patients with AD. Within the German Competence Network on Dementia, we conducted a 1H-MRS study in patients with mild dementia and mild cognitive impairment (MCI) at four sites to investigate the multicenter feasibility of 1H-MRS.

Methods: In total, 130 patients with dementia (98 AD, 32 non-AD), 136 subjects with MCI (70 of AD type, 66 of non-AD type), and 45 unimpaired control subjects were included. Single-volume 1H-MRS of the left medial temporal lobe was performed at long and short echo times. Metabolites were quantified and metabolic ratios were determined.

Results: We found a significant reduction of NAA concentration in patients with AD as compared to healthy volunteers and compared to patients with MCI of AD type. NAA/Cr (creatine/phosphocreatine) was also lower in patients with AD compared to control subjects. NAA, choline compounds, and Cr were lower in patients with AD compared to patients with non-AD dementia.

Conclusions: We demonstrated the multicenter feasibility of proton magnetic resonance spectroscopy (1H-MRS) of the medial temporal lobe in mild dementia and mild cognitive impairment, which is a prerequisite for the application of 1H-MRS in large-scale clinical trials. Since the concentration measures of the metabolites are adjusted for brain tissue volume, these findings are indicators of biochemical pathology beyond brain atrophy.

Abbreviations: 1H-MRS = proton magnetic resonance spectroscopy; AD = Alzheimer disease; ADL = activities of daily living; ANOVA = analysis of variance; Cho = choline compounds; CND = Competence Network on Dementia; Cr = creatine/phosphocreatine; MCI = mild cognitive impairment; MI = myo-inositol; MTL = medial temporal lobe; NAA = N-acetylaspartate; TE = echo time; TR = repetition time; VOI = volume of interest.

This study is part of the German Competence Network on Dementia and was funded by the German Federal Ministry for Education and Research (Bundesministerium für Bildung und Forschung [BMBF]), grant O1GI 0102.

Disclosure: The authors report no disclosures.

Medical Devices: 1.5 T Philips Gyroscan Intera (Philips, Best, Netherlands); 1.5 T Siemens Magnetom Vision, 1.5 T Siemens Magnetom Sonata (Siemens, Erlangen, Germany).

Received October 17, 2008. Accepted in final form February 11, 2009.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2009 by AAN Enterprises, Inc.