Probable Alzheimer disease: diagnosis with proton MR spectroscopy.
OBJECTIVE
To distinguish probable Alzheimer disease (AD) from other dementias (ODs) and normality in the elderly.


METHODS
A double-blind trial of proton magnetic resonance (MR) spectroscopy was performed, principally in gray matter, in the occipital cortex of 114 patients with dementia (AD [n = 65], OD [n = 39], or frontal lobe dementia [FLD] [n = 10]), 98 patients without dementia, and 32 healthy control subjects.


RESULTS
Reduced levels of N-acetylaspartate (NAA) (P < .0005) and increased levels of myo-inositol (MI) (P < .0005) characterize AD. Patients with OD had significantly reduced levels of NAA (P < .01) but normal levels of MI (P [vs AD] < .0005). When MI/NAA was used, AD was distinguished from normality with 83% sensitivity and 98% specificity. When MI/creatine was used, OD was distinguished from AD and FLD with a negative predictive rate of 80%, sensitivity of 82%, and specificity of 64%.


CONCLUSIONS
Hydrogen-1 MR spectroscopy enables identification of mild to moderate AD with a specificity and sensitivity that suggest clinical utility.
Shonk
T K
TK
Magnetic Resonance Spectroscopy Unit, Huntington Medical Research Institutes, Pasadena, CA 91105.
Moats
R A
RA
Gifford
P
P
Michaelis
T
T
Mandigo
J C
JC
Izumi
J
J
Ross
B D
BD
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis*; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000378:metabolism*; D001928:Brain Diseases, Metabolic / Q000175:diagnosis; D003401:Creatine / Q000378:metabolism; D003704:Dementia / Q000175:diagnosis; D003937:Diagnosis, Differential; D004311:Double-Blind Method; D006801:Humans; D007294:Inositol / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
D001224:Aspartic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003401:Creatine