title: [1H-MR spectroscopic imaging in patients with clinically diagnosed Alzheimer's disease].
abstract: OBJECTIVE
  To detect regional differences in accompanying metabolic changes, 1H-Magnetic Resonance Spectroscopic Imaging (MRSI) was performed in 16 patients with Alzheimer's disease (AD); the clinical diagnosis was based upon DSM-III-R and NINCDS-ADRDA guidelines.
  
  
  METHODS
  In the hippocampal region metabolic maps of the local distribution of N-acetylaspartate (NAA), choline (Cho), creatine compounds (P(Cr)) and lactate were determined. Ratios of Cho/NAA, (P)Cr/NAA and Cho/(P)Cr calculated from selected hippocampal spectra were compared to those from healthy volunteers (n = 17).
  
  
  RESULTS
  AD patients demonstrated an increase of Cho/NAA and (P)Cr/NAA ratios caused by increased choline compounds and decreased NAA. These alterations were observed in 11/12 cases in the hippocampal and in 7/12 in the temporo-occipital region. Hippocampal Cho/NAA ratios (0.56 +/- 0.19) were significantly elevated compared with controls (0.33 +/- 0.04; p < 0.0001).
  
  
  CONCLUSIONS
  The observed elevation of choline compounds in the hippocampus supports the hypothesis that alterations in the cholinergic system play an important role in Alzheimer's disease. The observed reduction of NAA is due to neuronal degeneration.
authors.affiliation: Radiologische Klinik Universität Bonn.
authors.forename: W
authors.initials: W
authors.lastname: Block
authors.forename: F
authors.initials: F
authors.lastname: Träber
authors.forename: C K
authors.initials: CK
authors.lastname: Kuhl
authors.forename: M
authors.initials: M
authors.lastname: Fric
authors.forename: E
authors.initials: E
authors.lastname: Keller
authors.forename: R
authors.initials: R
authors.lastname: Lamerichs
authors.forename: H
authors.initials: H
authors.lastname: Rink
authors.forename: H J
authors.initials: HJ
authors.lastname: Möller
authors.forename: H H
authors.initials: HH
authors.lastname: Schild
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000378:metabolism*; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000378:metabolism*; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D006624:Hippocampus / Q000378:metabolism; D006801:Humans; D007773:Lactates / Q000378:metabolism; D019344:Lactic Acid; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D009316:National Institutes of Health (U.S.); D009778:Occipital Lobe / Q000378:metabolism; D011569:Psychiatric Status Rating Scales; D013702:Temporal Lobe / Q000378:metabolism; D014481:United States
chemical_list: D007773:Lactates; D001224:Aspartic Acid; D019344:Lactic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline