title: A multicenter (1)H-MRS study of the medial temporal lobe in AD and MCI.
abstract: OBJECTIVE
  The need for biological markers of Alzheimer disease (AD) is constantly increasing. Proton magnetic resonance spectroscopy ((1)H-MRS) studies have provided consistent evidence for a reduction of the neuronal marker N-acetylaspartate (NAA) in patients with AD. Within the German Competence Network on Dementia, we conducted a (1)H-MRS study in patients with mild dementia and mild cognitive impairment (MCI) at four sites to investigate the multicenter feasibility of (1)H-MRS.
  
  
  METHODS
  In total, 130 patients with dementia (98 AD, 32 non-AD), 136 subjects with MCI (70 of AD type, 66 of non-AD type), and 45 unimpaired control subjects were included. Single-volume (1)H-MRS of the left medial temporal lobe was performed at long and short echo times. Metabolites were quantified and metabolic ratios were determined.
  
  
  RESULTS
  We found a significant reduction of NAA concentration in patients with AD as compared to healthy volunteers and compared to patients with MCI of AD type. NAA/Cr (creatine/phosphocreatine) was also lower in patients with AD compared to control subjects. NAA, choline compounds, and Cr were lower in patients with AD compared to patients with non-AD dementia.
  
  
  CONCLUSIONS
  We demonstrated the multicenter feasibility of proton magnetic resonance spectroscopy ((1)H-MRS) of the medial temporal lobe in mild dementia and mild cognitive impairment, which is a prerequisite for the application of (1)H-MRS in large-scale clinical trials. Since the concentration measures of the metabolites are adjusted for brain tissue volume, these findings are indicators of biochemical pathology beyond brain atrophy.
authors.affiliation: Department of Psychiatry, University of Bonn, Germany. Jessen@uni-bonn.de
authors.forename: F
authors.initials: F
authors.lastname: Jessen
authors.forename: O
authors.initials: O
authors.lastname: Gür
authors.forename: W
authors.initials: W
authors.lastname: Block
authors.forename: G
authors.initials: G
authors.lastname: Ende
authors.forename: L
authors.initials: L
authors.lastname: Frölich
authors.forename: T
authors.initials: T
authors.lastname: Hammen
authors.forename: J
authors.initials: J
authors.lastname: Wiltfang
authors.forename: T
authors.initials: T
authors.lastname: Kucinski
authors.forename: H
authors.initials: H
authors.lastname: Jahn
authors.forename: R
authors.initials: R
authors.lastname: Heun
authors.forename: W
authors.initials: W
authors.lastname: Maier
authors.forename: H
authors.initials: H
authors.lastname: Kölsch
authors.forename: J
authors.initials: J
authors.lastname: Kornhuber
authors.forename: F
authors.initials: F
authors.lastname: Träber
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology*; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D003072:Cognition Disorders / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D013702:Temporal Lobe / Q000033:anatomy & histology / Q000378:metabolism / Q000473:pathology*
chemical_list: D015415:Biomarkers; D001224:Aspartic Acid; C000179:N-acetylaspartate