title: Hippocampal metabolic abnormalities in mild cognitive impairment and Alzheimer's disease.
abstract: Mild cognitive impairment (MCI) defines a group of otherwise healthy elderly subjects with a markedly elevated risk of developing Alzheimer's disease (AD). In the search for biomarkers of MCI, we assessed whether MCI shares neurochemical abnormalities with AD in areas affected early in the course of the disease. As a secondary study aim, we tested to what extent neurochemical findings reflect neuropsychological deficits. Proton spectroscopy was performed in 19 MCI patients, 18 AD patients and 22 age and gender matched controls (CON) within the parietal gray and white matter (PWM and PGM) and the hippocampus (HIP). The cognitive test battery used included measures compiled by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD). The N-acetyl-aspartate to creatine ratio (NAA/Cr) was significantly reduced in the HIP of MCI and AD compared with CON (p < 0.05). Only AD patients showed parietal abnormalities, namely significantly elevated myoinositol (mI/Cr and mI/NAA) in PGM, reduced NAA/Cr and elevated mI/NAA in PWM. MCI subjects were significantly impaired in categorical verbal fluency (VF) (p < 0.001) and delayed verbal recall (DVR) (p < 0.001). VF was positively correlated with hippocampal NAA/Cr (p < 0.05) and parietal mI/NAA (p < 0.05). In summary, this study demonstrates shared neurobiological hippocampal abnormalities in MCI and AD, whereas parietal lobe neurochemical profiles and functions were normal in MCI. Thus, biological evidence is provided that MCI represents a precursor stage of AD. Moreover, multivoxel 1H MRS may enable an objective staging of the neurodegenerative process underlying the age-dependent cognitive deficits eventually leading to dementia.
authors.affiliation: Department of Psychiatry, Memory Clinic, Max-Planck-Institute of Psychiatry, Kraepelinstrasse 2-10, 80802 Munich, Germany. ackl@mpipsykl.mpg.de
authors.forename: Nibal
authors.initials: N
authors.lastname: Ackl
authors.forename: Marcus
authors.initials: M
authors.lastname: Ising
authors.forename: Yvonne A
authors.initials: YA
authors.lastname: Schreiber
authors.forename: Monika
authors.initials: M
authors.lastname: Atiya
authors.forename: Annette
authors.initials: A
authors.lastname: Sonntag
authors.forename: Dorothee P
authors.initials: DP
authors.lastname: Auer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000378:metabolism* / Q000503:physiopathology; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001931:Brain Mapping; D016022:Case-Control Studies; D002794:Choline / Q000378:metabolism; D003072:Cognition Disorders / Q000209:etiology / Q000378:metabolism*; D003401:Creatine / Q000378:metabolism; D005260:Female; D006624:Hippocampus / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D007294:Inositol / Q000378:metabolism; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D011939:Mental Recall / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D014705:Verbal Behavior / Q000502:physiology
chemical_list: D001224:Aspartic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline