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Regional N-Acetylaspartate Reduction in the Hippocampus Detected With Fast Proton Magnetic Resonance Spectroscopic Imaging in Patients With Alzheimer Disease
Wolfgang Block, PhD;
Frank Jessen, MD;
Frank Träber, PhD;
Sebastian Flacke, MD;
Christoph Manka, MD;
Rolf Lamerichs, PhD;
Ewald Keller, MD;
Reinhard Heun, MD;
Hans Schild, MD
Arch Neurol. 2002;59:828-834.
Objective To detect regional metabolic changes that resemble the expected spatial
pattern of neuronal loss in patients with Alzheimer disease (AD).
Methods Thirty-four patients with AD and 22 healthy control subjects were included
in the study. Single-slice fast proton spectroscopic imaging was performed
in parallel angulation to the temporal lobes. Proton spectra were selected
from the hippocampus, the lateral temporal lobe, and the occipital lobe of
both hemispheres to determine metabolite concentration of N-acetylaspartate (NAA), total creatine (tCr), including phosphocreatine
and creatine, and choline-containing compounds (Cho). The metabolic ratios
of NAA/tCr and Cho/tCr were calculated and compared between patients with
AD and healthy volunteers.
Results The NAA/tCr ratios were significantly reduced in the left (F1,1 = 4.34, P = .04) and right hippocampus (F1,1 = 9.96, P = .003) in patients with AD.
The Cho/tCr ratios remained unchanged in both hippocampi. There was no significant
change of either NAA/tCr or Cho/tCr in the lateral temporal and occipital
lobes of patients with AD.
Conclusion This study provides evidence that fast proton spectroscopic imaging
may detect the regional pattern of disturbed neuronal integrity in patients
with AD with high spatial resolution in a short acquisition time.
From the Departments of Radiology (Drs Block, Träber, Flacke,
Manka, Keller, and Schild) and Psychiatry (Drs Jessen and Heun), University
of Bonn, Bonn, Germany; and Philips Medical Systems, Best, the Netherlands
(Dr Lamerichs).
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