Contribution of 1H spectroscopy to a brief cognitive-functional test battery for the diagnosis of mild Alzheimer's disease.
OBJECTIVE
The diagnosis of mild or questionable Alzheimer's disease (AD) depends on clinical criteria that often leave a margin for doubt. We aim to verify the diagnostic accuracy of amnestic mild cognitive impairment (aMCI) and AD with proton spectroscopy (1H-MRS) combined with brief cognitive-functional scales.


METHODS
The relationship between 1H-MRS of the posterior cingulate cortex and the cognitive performance in Mini Mental State Examination, Blessed-Roth Dementia Rating and Functional Assessment Staging of Alzheimer Disease scales were investigated in 25 AD, 10 aMCI and 33 normal control (NC) individuals.


RESULTS
The N-acetylaspartate (NAA)/creatine and myoinositol/NAA ratios distinguished AD patients from NC (p<0.005), and added value in diagnostic accuracy and specificity by discriminant function analysis when combined to clinical diagnosis and simple neuropsychiatric scales; an increase of 3.7% (for aMCI patients) and of 5% (for AD individuals) was observed in diagnostic accuracy, and one of 5.5% (aMCI) and of 11.1% (AD) in specificity.


CONCLUSIONS
1H-MRS combined with brief cognitive-functional scales provided maximum diagnostic accuracy of AD patients, and can be useful when subtle cognitive and memory dysfunction is present.
D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil. andrea.silveiradesouza@gmail.com
Andrea
A
Silveira de Souza
Ricardo
R
de Oliveira-Souza
Jorge
J
Moll
Fernanda
F
Tovar-Moll
Pedro Angelo
PA
Andreiuolo
Cássio M C
CM
Bottino
D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis*; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D060825:Cognitive Dysfunction / Q000175:diagnosis*; D003401:Creatine / Q000378:metabolism*; D003937:Diagnosis, Differential; D005260:Female; D006179:Gyrus Cinguli / Q000378:metabolism; D006801:Humans; D007294:Inositol / Q000378:metabolism*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D010296:Parietal Lobe / Q000378:metabolism; D011237:Predictive Value of Tests; D012016:Reference Values; D013702:Temporal Lobe / Q000378:metabolism
D001224:Aspartic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003401:Creatine