title: Altered neurochemical metabolites in Alzheimer's disease patients with unawareness of deficits.
abstract: BACKGROUND
  Unawareness of deficits is common and is associated with poor outcomes in Alzheimer's disease (AD); however, little is known about correlated neurobiochemical changes.
  
  
  METHODS
  Proton magnetic resonance spectroscopy was used to examine neurobiochemical correlates of unawareness of deficits as assessed by the Dementia Deficit Scale in 36 patients with AD. Magnetic resonance spectroscopy spectra were acquired from the anterior cingulate area and right orbitofrontal area. Concentrations of N-acetyl-aspartate (NAA), total creatine, and other neurometabolites were calculated.
  
  
  RESULTS
  Nineteen (52.8%) participants had relative unawareness of deficits. This condition was negatively correlated with NAA/creatine in the anterior cingulate area (β = -0.36, p = 0.025) and positively correlated with NAA/creatine in the right orbitofrontal area (β = 0.41, p = 0.009) after controlling for dementia severity.
  
  
  CONCLUSIONS
  These findings suggest unawareness of deficits in AD was associated with the altered neurochemical metabolites in the anterior cingulate area and right orbitofrontal area. However, the two areas might have opposite neuronal functions in unawareness of deficits.
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Yeh
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Cheng-Fang
authors.initials: CF
authors.lastname: Yen
authors.affiliation: Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Chun-Wei
authors.initials: CW
authors.lastname: Li
authors.affiliation: Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Kuo
authors.affiliation: College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Chia-Hui
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Department of Radiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan.
authors.forename: Chen-Chang
authors.initials: CC
authors.lastname: Lee
authors.affiliation: Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Gin-Chung
authors.initials: GC
authors.lastname: Liu
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Mei-Feng
authors.initials: MF
authors.lastname: Huang
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Tai-Ling
authors.initials: TL
authors.lastname: Liu
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Cheng-Sheng
authors.initials: CS
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000503:physiopathology* / Q000523:psychology*; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001364:Awareness / Q000502:physiology*; D003401:Creatine / Q000378:metabolism*; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009483:Neuropsychological Tests; D011379:Prognosis; D012016:Reference Values
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine