Table 2. Summary of 1H-MRS Findings in Alzheimer's Disease

[email protected]

Study MR Protocol Salient Findings

Miller et al (1993) 1.5T STEAM Parietal Cortex:

Te = 30 1. NAA/Cr  5% in AD

2. MI/Cr  11% in AD

Occipital Cortex:

1. NAA/Cr  11% in AD

2. MI/Cr  22% in AD

Moats et al (1994) 1.5T STEAM 1. NAA  11% in AD

Various Te 2. MI  50% in AD

3. No Cho changes in AD

Meyerhoff et al 2T CSI PRESS 1. NAA/Cr  12% in WM only

(1994) Te = 272 2. Chol/Cr  23% GM only

Follow up in posterior parietal area showed:

1. 30%  Chol/Cr in mesial GM

2. 27%  Chol/Cr in lateral WM [email protected]

Mohankrishnan et Post-mortem 1. NAA depletion correlated with AD pathology al (1995) in vitro

Shonk et al (1995) 1.5T STEAM 1. AD, FTD, OD 10% in NAA/Cr

Te = 30 2. AD & FTD 15% in MI/Cr

3. No Cho/Cr differences

4. MRS discrimination of AD from:

. Controls: Positive Predictive Value: 98%

. Other Dementias: Positive Predictive Value:

74%; Negative Predictive Value: 80%

Parnetti et al 1.5T STEAM 1. AD and AAMI NAA  12%

(1996) Te = 20 2. AD MI  22%; AAMI ns increase.

3. No group Cho or Cr differences.

Parnetti et al 1.5T STEAM 1. AD  NAA in GM (15%) and WM (8%)

(1997) Te = 35 2. AD  MI 18% in grey matter only.

3. NAA/MI 100% discrimination of AD

4. Frontal WM MI & AD duration r= 0.70

Heun et al (1997) 1.5T PRESS 1. AD 16%  in NAA in WM

Te = 136 [email protected]

2. No MI differences.

3. NAA/Cho associated with Blessed Dementia

rating (r=-0.69) and MMSE (r=0.82)

Satlin et al (1997) 1.5T STEAM 1. Six-month placebo control trial of xanomeline

Te = 272 2. Repeat spectra found Cho/Cr decrease of

about 20% compared to baseline in medication

subjects only.

Doraiswamy et al 1.5T CSI 1. Baseline MI/NAA strongly negatively

(1998) correlated to MMSE score 12 months later (r=-

0.70).

Rose et al (1999) 2T VOSY 1. Same day test-retest correlation of metabolite

ratios was high. Te = 30

2. Longitudinal test-retest correlation of

metabolite ratios was high for all ratios except

Cho/Cr (r=0.50).

3. AD patients has significantly  NAA (15%)

and  MI (18%).

4. NAA/MI highly correlated with MMSE

(r=0.8).

Pfefferbaum et al 1.5T CSI 1. Gray matter NAA  in AD after controlling

(1999)

Table 2 continued over page… [email protected]

for brain volume.

2. Gray matter Cho  in AD.

3. Higher Cho related to lower face-recognition

scores (r= -0.7); higher Cr related to lower word

recognition scores (r= -0.67).

Rai et al (1999) 1.0T STEAM 1. Lower field strength MR scanners can also

Te = 30 replicate abnormal MI/Cr elevation in AD

2. Distribution of MI/Cr showed almost no

overlap between AD and MID patients

Kantarci et al 1.5T PRESS 1. Three VOI: medial occipital, posterior

(2000) cingulate (PC) and left superior temporal lobe Te= 135 & 30 (STL).

2. AD  NAA in STL and PC compared to MCI

or Controls

3. PC MI  in MCI and AD compared to

controls [email protected]

Jessen et al (2000) PRESS 1. AD medial temporal lobe (MTL) VOI showed

 NAA compared to controls and compared to Te=272 within-individual primary motor cortex

(PMC).

2. No Cho changes in medial temporal lobe.

3. NAA change (MTL/PMC) predicted MMSE

and ADAScog scores (r=-0.54)

Haley et al (2000) 1.5T STEAM 1. No NAA or Cho changes in hippocampus of

AD patients Te = 10

2. MI  in hippocampus 20%

Table 2. Summary of 1H-MRS findings in Alzheimer's disease.

All studies utilized the NINCDS-ADRDA criteria for AD diagnosis. Te = Echo time (msec). Groups: AD= Alzheimer's disease, AAMI= Age Associated Memory Impairment, MCI = Mild Cognitive Impairment, FTD= Fronto-temporal Dementia, MID = Multi Infarct Dementia, OD = Other Dementias, C= Controls, GM= Grey matter, WM= White Matter. ADAScog = Alzheimer Disease Assessment Scale cognitive subscale.