title: A decrease in N-acetylaspartate and an increase in myoinositol in the anterior cingulate gyrus are associated with behavioral and psychological symptoms in Alzheimer's disease.
abstract: OBJECTIVE
  The cognitive decline in Alzheimer's disease (AD) patients has been reported to involve alterations in the medial temporal lobe and the posterior cingulate gyrus. On the other hand, the neurochemical pathologies of the behavioral and psychological symptoms of dementia (BPSD) have not been sufficiently discussed. The aim of this study was to clarify the pathologies of BPSD in AD patients.
  
  
  METHODS
  Thirty patients with probable AD were included and underwent the following assessments: Mini Mental State Examination (MMSE), Clock Drawing Test (CDT), Story Recall Test (SRT), Behavioral pathology in Alzheimer's disease (BEHAVE-AD) and proton MRS ((1)H-MRS). None of them had been medicated for BPSD.
  
  
  RESULTS
  The MRS study revealed that MMSE, CDT, and SRT scores were positively related to N-acetyl-aspartate (NAA)/creatine(Cr) and negatively related to myoinositol (mI)/Cr in the posterior cingulate gyrus, but not in the anterior cingulate gyrus. On the other hand, the scores obtained in two categories of BEHAVE-AD (delusional thought/ activity disturbances) were negatively related with NAA/Cr and positively related with mI/Cr in the anterior cingulate gyrus, but not in the posterior cingulate gyrus.
  
  
  CONCLUSIONS
  We conclude that BPSD and the decline in cognitive function in AD might have separate pathologies.
authors.affiliation: Department of Psychiatry, Shimane University Faculty of Medicine, Izumo, Japan. shinnoh@med.kagawa-u.ac.jp
authors.forename: Hideto
authors.initials: H
authors.lastname: Shinno
authors.forename: Takuji
authors.initials: T
authors.lastname: Inagaki
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Miyaoka
authors.forename: Shihoh
authors.initials: S
authors.lastname: Okazaki
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kawamukai
authors.forename: Etsuko
authors.initials: E
authors.lastname: Utani
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Inami
authors.forename: Jun
authors.initials: J
authors.lastname: Horiguchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000378:metabolism* / Q000503:physiopathology / Q000523:psychology; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000032:analysis / Q000172:deficiency / Q000378:metabolism; D001923:Brain Chemistry / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D003401:Creatine / Q000032:analysis / Q000378:metabolism; D015536:Down-Regulation / Q000502:physiology; D005260:Female; D006179:Gyrus Cinguli / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D007294:Inositol / Q000032:analysis / Q000378:metabolism*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D001523:Mental Disorders / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D019965:Neurocognitive Disorders / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D015854:Up-Regulation / Q000502:physiology
chemical_list: D001224:Aspartic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003401:Creatine