title: Probable Alzheimer disease: diagnosis with proton MR spectroscopy.
abstract: 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.
authors.affiliation: Magnetic Resonance Spectroscopy Unit, Huntington Medical Research Institutes, Pasadena, CA 91105.
authors.forename: T K
authors.initials: TK
authors.lastname: Shonk
authors.forename: R A
authors.initials: RA
authors.lastname: Moats
authors.forename: P
authors.initials: P
authors.lastname: Gifford
authors.forename: T
authors.initials: T
authors.lastname: Michaelis
authors.forename: J C
authors.initials: JC
authors.lastname: Mandigo
authors.forename: J
authors.initials: J
authors.lastname: Izumi
authors.forename: B D
authors.initials: BD
authors.lastname: Ross
mesh_terms: 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
chemical_list: D001224:Aspartic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003401:Creatine