title: Higher glutamate+glutamine and reduction of N-acetylaspartate in posterior cingulate according to age range in patients with cognitive impairment and/or pain.
abstract: OBJECTIVE
  The aim of the study was to analyze 1) whether the metabolite levels in the posterior cingulate cortex (PCC) are different in healthy individuals compared to a group of patients with cognitive impairment and/or pain and 2) whether there exists a correlation between brain metabolites and the age of a patient.
  
  
  METHODS
  Two hundred seven patients with cognitive impairment and/or pain (66 mild cognitive impairment, 54 fibromyalgia, 36 Alzheimer disease, 33 interictal migraine, 10 somatization disorder, and 8 after trigeminal neuralgia, and 193 healthy participants adjusted for gender and age. Proton magnetic resonance spectroscopy (MRS) of the brain was performed with the voxel placed in the ventral PCC and postprocessed with LCModel (Stephen Provencher, Oakville, Ontario, Canada).
  
  
  RESULTS
  Using linear regression and adjusting for gender and age, mean brain metabolite values for the pathological group, when compared to healthy controls, were significantly lower in N-acetylaspartate (P=.003) and N-acetylaspartate/creatine (P=.015) and significantly greater in glutamate+glutamine (P<.001) and glutamate+glutamine/creatine (P<.000). All metabolites were significantly correlated with age: glutamate, glutamate+glutamine, N-acetylaspartate, and their creatine ratios exhibited a negative correlation, whereas myoinositol and choline exhibited a positive correlation.
  
  
  CONCLUSIONS
  Although the number of patients is relatively small with heterogeneous state of disease, MRS in PCC may serve as a useful noninvasive tool for diagnostic of patients with cognitive impairment and pain.
authors: Department of Radiology, Quirón Hospital, Zaragoza, Spain.
authors: Nicolás
authors: N
authors: Fayed
authors: CIBER Epidemiology and Public Health, Clinic Epidemiology Unit, 12 de Octubre Hospital, Madrid, Spain.
authors: Eva
authors: E
authors: Andrés
authors: Department of Radiology, Quirón Hospital, Zaragoza, Spain.
authors: Laura
authors: L
authors: Viguera
authors: Department of Neurology, Miguel Servet Hospital, Zaragoza, Spain.
authors: Pedro J
authors: PJ
authors: Modrego
authors: Department of Psychiatry, Aragonese Institute of Health Sciences, Miguel Servet Hospital and University of Zaragoza, Zaragoza, Spain. Electronic address: jgarcamp@gmail.com.
authors: Javier
authors: J
authors: Garcia-Campayo
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000378:metabolism*; D003401:Creatine / Q000378:metabolism; D005260:Female; D018698:Glutamic Acid / Q000378:metabolism*; D005973:Glutamine / Q000378:metabolism*; D006179:Gyrus Cinguli / Q000378:metabolism*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000378:metabolism*; D011446:Prospective Studies
chemical_list: D005973:Glutamine; D001224:Aspartic Acid; D018698:Glutamic Acid; C000179:N-acetylaspartate; D003401:Creatine
keywords: Cognitive impairment; magnetic resonance spectroscopy; pain; posterior cingulate cortex voxel