title: MRS in mild cognitive impairment: early differentiation of dementia with Lewy bodies and Alzheimer's disease.
abstract: OBJECTIVE
  Mild cognitive impairment (MCI) precedes both Alzheimer's disease (AD) dementia and with Lewy bodies (DLB). We investigated proton magnetic resonance spectroscopy (MRS) characteristics of MCI patients who progressed to DLB compared to those who progressed to AD dementia or remained stable.
  
  
  METHODS
  Consecutive MCI patients who underwent single voxel MRS at baseline and progressed to DLB (n = 10) were identified during a median follow-up period of 18 months. From the same cohort, we identified age- and sex-matched MCI patients who progressed to AD dementia (n = 27) or remained stable (n = 20) during a similar follow-up period. This study was approved by the Institutional Review Board and informed consent was from every subject.
  
  
  RESULTS
  MCI patients who progressed to AD dementia were characterized by lower N-acetylaspartate (NAA)/Cr ratio in the posterior cingulate voxel compared to those who progressed to DLB (P = .001). Decreased NAA/Cr in the posterior cingulate voxel differentiated MCI patients who progressed to DLB from those who progressed to AD with an area under the receiver operating characteristic curve of .85 (P < .001) on logistic regression analysis.
  
  
  CONCLUSIONS
  MRS may be useful in differentiating MCI patients with prodromal AD dementia from those with prodromal DLB for early disease-specific interventions.
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN.|Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL.
authors.forename: Tanis J
authors.initials: TJ
authors.lastname: Ferman
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, MN.
authors.forename: Bradley F
authors.initials: BF
authors.lastname: Boeve
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.
authors.forename: Glenn E
authors.initials: GE
authors.lastname: Smith
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN.
authors.forename: Mandie
authors.initials: M
authors.lastname: Maroney-Smith
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Spychalla
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, MN.
authors.forename: David S
authors.initials: DS
authors.lastname: Knopman
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN.
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Jack
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, MN.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Petersen
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN.
authors.forename: Kejal
authors.initials: K
authors.lastname: Kantarci
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000378:metabolism; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism*; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000175:diagnosis* / Q000378:metabolism; D008297:Male; D066244:Proton Magnetic Resonance Spectroscopy / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine
keywords: Alzheimer's disease; MRI; Magnetic resonance spectroscopy (MRS); dementia with Lewy Bodies (DLB); mild cognitive impairment (MCI)