1
|
Sheikh-Bahaei N, Chen M, Pappas I. Magnetic Resonance Spectroscopy (MRS) in Alzheimer's Disease. Methods Mol Biol 2024; 2785:115-142. [PMID: 38427192 DOI: 10.1007/978-1-0716-3774-6_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
MRS is a noninvasive technique to measure different metabolites in the brain. Changes in the levels of certain metabolites can be used as surrogate markers for Alzheimer's disease. They can potentially be used for diagnosis, prediction of prognosis, or even assessing response to treatment.There are different techniques for MRS acquisitions including STimulated Echo Acquisition Mode (STEAM) and Point Resolved Spectroscopy (PRESS). In terms of localization, single or multi-voxel methods can be used. Based on current data: 1. NAA, marker of neuronal integrity and viability, reduces in AD with longitudinal changes over the time as the disease progresses. There are data claiming that reduction of NAA is associated with tau accumulation, early neurodegenerative processes, and cognitive decline. Therefore, it can be used as a stage biomarker for AD to assess the severity of the disease. With advancement of disease modifying therapies, there is a potential role for NAA in the future to be used as a marker of response to treatment. 2. mI, marker of glial cell proliferation and activation, is associated with AB pathology and has early changes in the course of the disease. The NAA/mI ratio can be predictive of AD development with high specificity and can be utilized in the clinical setting to stratify cases for further evaluation with PET for potential treatments. 3. The changes in the level of other metabolites such as Chol, Glu, Gln, and GABA are controversial because of the lack of standardization of MRS techniques, current technical limitations, and possible region specific changes. 4. Ultrahigh field MRS and more advanced techniques can overcome many of these limitations and enable us to measure more metabolites with higher accuracy. 5. Standardization of MRS techniques, validation of metabolites' changes against PET using PET-guided technique, and longitudinal follow-ups to investigate the temporal changes of the metabolites in relation to other biomarkers and cognition will be crucial to confirm the utility of MRS as a potential noninvasive biomarker for AD.
Collapse
Affiliation(s)
- Nasim Sheikh-Bahaei
- Department of Radiology, Keck School of Medicine of USC, Los Angeles, CA, USA.
| | - Michelle Chen
- Keck School of Medicine of USC, USC, Los Angeles, CA, USA
| | - Ioannis Pappas
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, USC, Los Angeles, CA, USA
| |
Collapse
|
2
|
El Feil NS, Elmahdy HS, Elmahdy RA, Aboelezz AAE, Dawoud HS, Al-Beltagi M. Brain metabolic profile assessed by magnetic resonance spectroscopy in children with Down syndrome: Relation to intelligence quotient. World J Clin Pediatr 2023; 12:310-318. [PMID: 38178937 PMCID: PMC10762600 DOI: 10.5409/wjcp.v12.i5.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/18/2023] [Accepted: 09/28/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Down syndrome (DS) is one of the most common causes of intellectual disability. Children with DS have varying intelligence quotient (IQ) that can predict their learning abilities. AIM To assess the brain metabolic profiles of children with DS and compare them to standard controls, using magnetic resonance spectroscopy (MRS) and correlating the results with IQ. METHODS This case-control study included 40 children with DS aged 6-15 years and 40 age and sex-matched healthy children as controls. MRS was used to evaluate ratios of choline/creatine (Cho/Cr), N-acetyl aspartic acid/creatine (NAA/Cr), and myoinositol/creatine (MI/Cr (in the frontal, temporal, and occipital lobes and basal ganglia and compared to controls and correlated with IQ. RESULTS Children with DS showed significant reductions in NAA/Cr and MI/Cr and a non-significant reduction in Cho/Cr in frontal lobes compared to controls. Additionally, we observed significant decreases in NAA/Cr, MI/Cr, and Cho/Cr in the temporal and occipital lobes and basal ganglia in children with DS compared to controls. Furthermore, there was a significant correlation between IQ and metabolic ratios in the brains of children with DS. CONCLUSION Brain metabolic profile could be a good predictor of IQ in children with DS.
Collapse
Affiliation(s)
- Nesreen Safwat El Feil
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31527, Al Gharbia, Egypt
| | - Heba S Elmahdy
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31527, Al Gharbia, Egypt
| | - Rasha Ahmed Elmahdy
- Department of Radiology, University Medical Center, Dr. Sulaiman Al-Habib Medical Group, Manama 26671, Manama, Bahrain
| | | | - Heba S Dawoud
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31527, Al Gharbia, Egypt
| | - Mohammed Al-Beltagi
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31527, Al Gharbia, Egypt
- Department of Pediatrics, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
- Department of Pediatrics, University Medical Center, Dr. Sulaiman Al-Habib Medical Group, Manama 26671, Manama, Bahrain
| |
Collapse
|
3
|
Hatay GH, Ozturk-Isik E. Optimized multi-voxel TE-averaged PRESS for glutamate detection in the human brain at 3T. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2023; 356:107574. [PMID: 37922677 DOI: 10.1016/j.jmr.2023.107574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 10/20/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE To optimize possible combinations of echo times (TE) for multi-voxel TE-averaged Point RESolved Spectroscopy (PRESS) while reducing the total number of TEs required to separate glutamate (Glu) and glutamine (Gln) within a clinically feasible scan time. METHODS General Approach to Magnetic resonance Mathematical Analysis (GAMMA) was used to implement 2D J-resolved PRESS technique, and the spectra of 14 individual brain metabolites were simulated at 64 different TEs. Monte Carlo simulations were used for selecting the best TE combinations to separate Glu and Gln using TE-averaged PRESS with a total number of two, three, four and five TEs. Single-voxel 1H-MRS data were acquired using 64 different TEs from a healthy volunteer on a clinical 3T MR scanner to validate the echo time combinations selected with simulations. Additionally, 2D 1H-MRSI data of eight healthy volunteers were acquired on a clinical 3T MR scanner using four different TEs that were determined by Monte Carlo simulations. Optimized TE-averaged PRESS spectra were created by averaging the spectra acquired at selected TEs. LCModel was used for spectral quantification. A Wilcoxon signed-rank test was used to detect statistically significant differences in Glu/Gln ratios between 35 ms PRESS and optimized TE-averaged PRESS data. RESULTS Glu could be clearly separated from Gln at 2.35 ppm, using optimized TE-averaged PRESS with only four TEs (35, 37, 40, and 42 ms) that were selected through Monte Carlo simulations. Glu/Gln ratios were significantly higher in the optimized TE-averaged PRESS data of healthy volunteers than in the 35 ms PRESS data (P = 0.008). CONCLUSION Optimized multi-voxel TE-averaged PRESS enabled faster and unobstructed quantification of Glu at multiple voxels in the human brain in vivo at 3T.
Collapse
Affiliation(s)
- Gokce Hale Hatay
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey.
| | - Esin Ozturk-Isik
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey.
| |
Collapse
|
4
|
Gozdas E, Hinkley L, Fingerhut H, Dacorro L, Gu M, Sacchet MD, Hurd R, Hosseini SH. 1H-MRS neurometabolites and associations with neurite microstructures and cognitive functions in amnestic mild cognitive impairment. Neuroimage Clin 2022; 36:103159. [PMID: 36063758 PMCID: PMC9450331 DOI: 10.1016/j.nicl.2022.103159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/04/2022] [Accepted: 08/18/2022] [Indexed: 01/16/2023]
Abstract
Alzheimer's disease (AD) pathogenesis is associated with alterations in neurometabolites and cortical microstructure. However, our understanding of alterations in neurochemicals in the prefrontal cortex and their relationship with changes in cortical microstructure in AD remains unclear. Here, we studied the levels of neurometabolites in the left dorsolateral prefrontal cortex (DLPFC) in healthy older adults and patients with amnestic Mild Cognitive Impairments (aMCI) using single-voxel proton-magnetic resonance spectroscopy (1H-MRS). N-acetyl aspartate (NAA), glutamate+glutamate (Glx), Myo-inositol (mI), and γ-aminobutyric acid (GABA) brain metabolite levels were quantified relative to total creatine (tCr = Cr + PCr). aMCI had significantly decreased NAA/tCr, Glx/tCr, NAA/mI, and increased mI/tCr levels compared with healthy controls. Further, we leveraged advanced diffusion MRI to extract neurite properties in the left DLPFC and found a significant positive correlation between NAA/tCr, related to neuronal intracellular compartment, and neurite density (ICVF, intracellular volume fraction), and a negative correlation between mI/tCr and neurite orientation (ODI) only in healthy older adults. These data suggest a potential decoupling in the relationship between neurite microstructures and NAA and mI concentrations in DLPFC in the early stage of AD. Together, our results confirm altered DLPFC neurometabolites in prodromal phase of AD and provide unique evidence regarding the imbalance in the association between neurometabolites and neurite microstructure in early stage of AD.
Collapse
Affiliation(s)
- Elveda Gozdas
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA,Corresponding author at: Department of Psychiatry and Behavioral Sciences, CBRAIN Lab, 401 Quarry Rd., Stanford, CA 94305-5795, USA.
| | - Lauren Hinkley
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Hannah Fingerhut
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Lauren Dacorro
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Meng Gu
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Matthew D. Sacchet
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Ralph Hurd
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - S.M. Hadi Hosseini
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
5
|
Bellanti F, Bukke VN, Moola A, Villani R, Scuderi C, Steardo L, Palombelli G, Canese R, Beggiato S, Altamura M, Vendemiale G, Serviddio G, Cassano T. Effects of Ultramicronized Palmitoylethanolamide on Mitochondrial Bioenergetics, Cerebral Metabolism, and Glutamatergic Transmission: An Integrated Approach in a Triple Transgenic Mouse Model of Alzheimer's Disease. Front Aging Neurosci 2022; 14:890855. [PMID: 35686025 PMCID: PMC9170916 DOI: 10.3389/fnagi.2022.890855] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/19/2022] [Indexed: 01/26/2023] Open
Abstract
The therapeutic potential of ultramicronized palmitoylethanolamide (um-PEA) was investigated in young (6-month-old) and adult (12-month-old) 3 × Tg-AD mice, which received um-PEA for 3 months via a subcutaneous delivery system. Mitochondrial bioenergetics, ATP homeostasis, and magnetic resonance imaging/magnetic resonance spectroscopy were evaluated in the frontal cortex (FC) and hippocampus (HIPP) at the end of um-PEA treatment. Glutamate release was investigated by in vivo microdialysis in the ventral HIPP (vHIPP). We demonstrated that chronic um-PEA treatment ameliorates the decrease in the complex-I respiration rate and the FoF1-ATPase (complex V) activity, as well as ATP content depletion in the cortical mitochondria. Otherwise, the impairment in mitochondrial bioenergetics and the release of glutamate after depolarization was not ameliorated by um-PEA treatment in the HIPP of both young and adult 3 × Tg-AD mice. Moreover, progressive age- and pathology-related changes were observed in the cortical and hippocampal metabolism that closely mimic the alterations observed in the human AD brain; these metabolic alterations were not affected by chronic um-PEA treatment. These findings confirm that the HIPP is the most affected area by AD-like pathology and demonstrate that um-PEA counteracts mitochondrial dysfunctions and helps rescue brain energy metabolism in the FC, but not in the HIPP.
Collapse
Affiliation(s)
- Francesco Bellanti
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Archana Moola
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Rosanna Villani
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Caterina Scuderi
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Rome, Italy
| | - Luca Steardo
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Rome, Italy
| | | | - Rossella Canese
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Sarah Beggiato
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Mario Altamura
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Gianluigi Vendemiale
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Tommaso Cassano
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- *Correspondence: Tommaso Cassano
| |
Collapse
|
6
|
Melichercik L, Tvrdik T, Novakova K, Nemec M, Kalinak M, Baciak L, Kasparova S. Huperzine aggravated neurochemical and volumetric changes induced by D-galactose in the model of neurodegeneration in rats. Neurochem Int 2022; 158:105365. [DOI: 10.1016/j.neuint.2022.105365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 10/18/2022]
|
7
|
Goyzueta-Mamani LD, Chávez-Fumagalli MA, Alvarez-Fernandez K, Aguilar-Pineda JA, Nieto-Montesinos R, Davila Del-Carpio G, Vera-Lopez KJ, Lino Cardenas CL. Alzheimer's Disease: A Silent Pandemic - A Systematic Review on the Situation and Patent Landscape of the Diagnosis. Recent Pat Biotechnol 2022; 16:355-378. [PMID: 35400333 DOI: 10.2174/1872208316666220408114129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 01/13/2022] [Accepted: 02/17/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is characterized by cognitive impairment, tau protein deposits, and amyloid beta plaques. AD impacted 44 million people in 2016, and it is estimated to affect 100 million people by 2050. AD is disregarded as a pandemic compared with other diseases. To date, there is no effective treatment or diagnosis. OBJECTIVE We aimed to discuss the current tools used to diagnose COVID-19, to point out their potential to be adapted for AD diagnosis, and to review the landscape of existing patents in the AD field and future perspectives for AD diagnosis. METHOD We carried out a scientific screening following a research strategy in PubMed; Web of Science; the Derwent Innovation Index; the KCI-Korean Journal Database; SciELO; the Russian Science Citation index; and the CDerwent, EDerwent, and MDerwent index databases. RESULTS A total of 326 from 6,446 articles about AD and 376 from 4,595 articles about COVID-19 were analyzed. Of these, AD patents were focused on biomarkers and neuroimaging with no accurate, validated diagnostic methods, and only 7% of kit development patents were found. In comparison, COVID-19 patents were 60% about kit development for diagnosis; they are highly accurate and are now commercialized. CONCLUSION AD is still neglected and not recognized as a pandemic that affects the people and economies of all nations. There is a gap in the development of AD diagnostic tools that could be filled if the interest and effort that has been invested to tackle the COVID-19 emergency could also be applied for innovation.
Collapse
Affiliation(s)
- Luis Daniel Goyzueta-Mamani
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigacion, Universidad Catolica de Santa Maria, Arequipa, Peru
| | - Miguel Angel Chávez-Fumagalli
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigacion, Universidad Catolica de Santa Maria, Arequipa, Peru
| | - Karla Alvarez-Fernandez
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigacion, Universidad Catolica de Santa Maria, Arequipa, Peru
| | - Jorge A Aguilar-Pineda
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigacion, Universidad Catolica de Santa Maria, Arequipa, Peru
| | - Rita Nieto-Montesinos
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigacion, Universidad Catolica de Santa Maria, Arequipa, Peru
| | - Gonzalo Davila Del-Carpio
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigacion, Universidad Catolica de Santa Maria, Arequipa, Peru
| | - Karin J Vera-Lopez
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigacion, Universidad Catolica de Santa Maria, Arequipa, Peru
| | - Christian L Lino Cardenas
- Cardiovascular Research Center, Cardiology Division, Massachusetts General Hospital, Boston, MA, USA
| |
Collapse
|
8
|
Tomiyasu M, Harada M. In vivo Human MR Spectroscopy Using a Clinical Scanner: Development, Applications, and Future Prospects. Magn Reson Med Sci 2022; 21:235-252. [PMID: 35173095 PMCID: PMC9199975 DOI: 10.2463/mrms.rev.2021-0085] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
MR spectroscopy (MRS) is a unique and useful method for noninvasively evaluating biochemical metabolism in human organs and tissues, but its clinical dissemination has been slow and often limited to specialized institutions or hospitals with experts in MRS technology. The number of 3-T clinical MR scanners is now increasing, representing a major opportunity to promote the use of clinical MRS. In this review, we summarize the theoretical background and basic knowledge required to understand the results obtained with MRS and introduce the general consensus on the clinical utility of proton MRS in routine clinical practice. In addition, we present updates to the consensus guidelines on proton MRS published by the members of a working committee of the Japan Society of Magnetic Resonance in Medicine in 2013. Recent research into multinuclear MRS equipped in clinical MR scanners is explained with an eye toward future development. This article seeks to provide an overview of the current status of clinical MRS and to promote the understanding of when it can be useful. In the coming years, MRS-mediated biochemical evaluation is expected to become available for even routine clinical practice.
Collapse
Affiliation(s)
- Moyoko Tomiyasu
- Department of Molecular Imaging and Theranostics, National Institutes for Quantum Science and Technology.,Department of Radiology, Kanagawa Children's Medical Center
| | - Masafumi Harada
- Department of Radiology and Radiation Oncology, Graduate School of Biomedical Sciences, Tokushima University
| |
Collapse
|
9
|
Chávez-Fumagalli MA, Shrivastava P, Aguilar-Pineda JA, Nieto-Montesinos R, Del-Carpio GD, Peralta-Mestas A, Caracela-Zeballos C, Valdez-Lazo G, Fernandez-Macedo V, Pino-Figueroa A, Vera-Lopez KJ, Lino Cardenas CL. Diagnosis of Alzheimer's Disease in Developed and Developing Countries: Systematic Review and Meta-Analysis of Diagnostic Test Accuracy. J Alzheimers Dis Rep 2021; 5:15-30. [PMID: 33681713 PMCID: PMC7902992 DOI: 10.3233/adr-200263] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The present systematic review and meta-analysis of diagnostic test accuracy summarizes the last three decades in advances on diagnosis of Alzheimer's disease (AD) in developed and developing countries. OBJECTIVE To determine the accuracy of biomarkers in diagnostic tools in AD, for example, cerebrospinal fluid, positron emission tomography (PET), and magnetic resonance imaging (MRI), etc. METHODS The authors searched PubMed for published studies from 1990 to April 2020 on AD diagnostic biomarkers. 84 published studies were pooled and analyzed in this meta-analysis and diagnostic accuracy was compared by summary receiver operating characteristic statistics. RESULTS Overall, 84 studies met the criteria and were included in a meta-analysis. For EEG, the sensitivity ranged from 67 to 98%, with a median of 80%, 95% CI [75, 91], tau-PET diagnosis sensitivity ranged from 76 to 97%, with a median of 94%, 95% CI [76, 97]; and MRI sensitivity ranged from 41 to 99%, with a median of 84%, 95% CI [81, 87]. Our results showed that tau-PET diagnosis had higher performance as compared to other diagnostic methods in this meta-analysis. CONCLUSION Our findings showed an important discrepancy in diagnostic data for AD between developed and developing countries, which can impact global prevalence estimation and management of AD. Also, our analysis found a better performance for the tau-PET diagnostic over other methods to diagnose AD patients, but the expense of tau-PET scan seems to be the limiting factor in the diagnosis of AD in developing countries such as those found in Asia, Africa, and Latin America.
Collapse
Affiliation(s)
- Miguel A. Chávez-Fumagalli
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigación, Universidad Católica de Santa Maria, Arequipa, Peru
| | - Pallavi Shrivastava
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigación, Universidad Católica de Santa Maria, Arequipa, Peru
| | - Jorge A. Aguilar-Pineda
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigación, Universidad Católica de Santa Maria, Arequipa, Peru
| | - Rita Nieto-Montesinos
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigación, Universidad Católica de Santa Maria, Arequipa, Peru
| | - Gonzalo Davila Del-Carpio
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigación, Universidad Católica de Santa Maria, Arequipa, Peru
| | - Antero Peralta-Mestas
- Division of Neurology, Psychiatry and Radiology of the National Hospital ESSALUD-HNCASE, Arequipa, Peru
| | - Claudia Caracela-Zeballos
- Division of Neurology, Psychiatry and Radiology of the National Hospital ESSALUD-HNCASE, Arequipa, Peru
| | - Guillermo Valdez-Lazo
- Division of Neurology, Psychiatry and Radiology of the National Hospital ESSALUD-HNCASE, Arequipa, Peru
| | - Victor Fernandez-Macedo
- Division of Neurology, Psychiatry and Radiology of the National Hospital ESSALUD-HNCASE, Arequipa, Peru
| | - Alejandro Pino-Figueroa
- Department of Pharmaceutical Sciences, Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA
| | - Karin J. Vera-Lopez
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigación, Universidad Católica de Santa Maria, Arequipa, Peru
| | - Christian L. Lino Cardenas
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigación, Universidad Católica de Santa Maria, Arequipa, Peru
- Cardiovascular Research Center, Cardiology Division, Massachusetts General Hospital, Boston, MA, USA
| |
Collapse
|
10
|
|
11
|
Villa C, Lavitrano M, Salvatore E, Combi R. Molecular and Imaging Biomarkers in Alzheimer's Disease: A Focus on Recent Insights. J Pers Med 2020; 10:jpm10030061. [PMID: 32664352 PMCID: PMC7565667 DOI: 10.3390/jpm10030061] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/28/2020] [Accepted: 07/07/2020] [Indexed: 12/15/2022] Open
Abstract
Alzheimer’s disease (AD) is the most common neurodegenerative disease among the elderly, affecting millions of people worldwide and clinically characterized by a progressive and irreversible cognitive decline. The rapid increase in the incidence of AD highlights the need for an easy, efficient and accurate diagnosis of the disease in its initial stages in order to halt or delay the progression. The currently used diagnostic methods rely on measures of amyloid-β (Aβ), phosphorylated (p-tau) and total tau (t-tau) protein levels in the cerebrospinal fluid (CSF) aided by advanced neuroimaging techniques like positron emission tomography (PET) and magnetic resonance imaging (MRI). However, the invasiveness of these procedures and the high cost restrict their utilization. Hence, biomarkers from biological fluids obtained using non-invasive methods and novel neuroimaging approaches provide an attractive alternative for the early diagnosis of AD. Such biomarkers may also be helpful for better understanding of the molecular mechanisms underlying the disease, allowing differential diagnosis or at least prolonging the pre-symptomatic stage in patients suffering from AD. Herein, we discuss the advantages and limits of the conventional biomarkers as well as recent promising candidates from alternative body fluids and new imaging techniques.
Collapse
Affiliation(s)
- Chiara Villa
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- Correspondence: (C.V.); (R.C.)
| | - Marialuisa Lavitrano
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- Institute for the Experimental Endocrinology and Oncology, National Research Council (IEOS-CNR), 80131 Naples, Italy;
| | - Elena Salvatore
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, 80131 Naples, Italy;
| | - Romina Combi
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- Correspondence: (C.V.); (R.C.)
| |
Collapse
|
12
|
Abstract
PURPOSE A mouse model of Alzheimer's disease demonstrates reduced beta-amyloid levels in the whole brain, associated with a gain of hippocampal memory, after drinking taurine-enriched water; this suggests that a taurine supplement could be a promising treatment for cognitive deficit. The objective of this study is to establish a methodology for quantifying taurine in the whole brain, taking advantage of the rapid development of non-invasive imaging techniques such as magnetic resonance imaging and magnetic resonance spectroscopy (MRS). PROCEDURES Single-voxel proton MRS was used to obtain quantifiable taurine peaks at 3.25 and 3.43 ppm. Quantitative MRS results were obtained in C57BL/6 mice of various age groups: 4, 11, 18, and 27 months old. RESULTS Compared with the 4-month-old group, taurine levels dropped significantly only at 27 months of age (p = 0.03). However, a significant decrease of N-acetyl-aspartate (NAA) in the brain was observed at both 18 and 27 months (p = 0.03 and p = 0.02). In addition, MRS-measured taurine level is highly correlated with hippocampal volume (r = 0.95). CONCLUSIONS These results suggest that decreased taurine levels in the brain could be used as biomarkers for hippocampal changes and are fully translatable into putative cognitive loss in both animal models and human studies without the ex vivo approach.
Collapse
|
13
|
Watanabe T, Tan Z, Wang X, Martinez-Hernandez A, Frahm J. Magnetic resonance imaging of noradrenergic neurons. Brain Struct Funct 2019; 224:1609-1625. [PMID: 30903359 PMCID: PMC6509075 DOI: 10.1007/s00429-019-01858-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 03/06/2019] [Indexed: 12/16/2022]
Abstract
Noradrenaline is a neurotransmitter involved in general arousal, selective attention, memory, inflammation, and neurodegeneration. The purpose of this work was to delineate noradrenergic neurons in vivo by T1-weighted MRI with magnetization transfer (MT). In the brainstem of human and mice, MRI identified the locus coeruleus, dorsal motor vagus nucleus, and nucleus tractus solitarius. Given (1) the long T1 and low magnetization transfer ratio for the noradrenergic cell groups compared to other gray matter, (2) significant correlation between MT MRI signal intensity and proton density, and (3) no correlation between magnetization transfer ratio (or R1) and iron, copper, or manganese in human brain, the high MRI signal of the noradrenergic neurons must be attributed to abundant water protons interacting with any T1-shortening paramagnetic ions in active cells rather than to specific T1-shortening molecules. The absence of a high MRI signal from the locus coeruleus of Ear2(-/-) mice lacking noradrenergic neurons confirms that cell bodies of noradrenergic neurons are the source of the bright MRI appearance. The observation of this high signal in DBH(-/-) mice, in 3-week-old mice, and in mice under hyperoxia/hypercapnia/hypoxia together with the general absence of neuromelanin (NM) in noradrenergic neurons of young rodents further excludes that it is due to NM, dopamine β-hydroxylase, their binding to paramagnetic ions, blood inflow, or hemoglobin. Instead, these findings indicate a high density of water protons whose T1 is shortened by paramagnetic ions as the relevant source of the high MRI signal. In the brain of APP/PS1/Ear2(-/-) mice, a transgenic model of Alzheimer's disease, MRI detected noradrenergic neuron loss in the locus coeruleus. Proton magnetic resonance spectroscopy revealed that a 60-75% reduction of noradrenaline is responsible for a reduction of N-acetylaspartate and glutamate in the hippocampus as well as for a shortening of the water proton T2 in the frontal cortex. These results suggest that a concurrent shortage of noradrenaline in Alzheimer's disease accelerates pathologic processes such as inflammation and neuron loss.
Collapse
Affiliation(s)
- Takashi Watanabe
- Biomedizinische NMR, Max-Planck-Institut für biophysikalische Chemie, 37077, Göttingen, Germany.
| | - Zhengguo Tan
- Biomedizinische NMR, Max-Planck-Institut für biophysikalische Chemie, 37077, Göttingen, Germany
| | - Xiaoqing Wang
- Biomedizinische NMR, Max-Planck-Institut für biophysikalische Chemie, 37077, Göttingen, Germany
| | - Ana Martinez-Hernandez
- Abteilung Gene und Verhalten, Max-Planck-Institut für biophysikalische Chemie, 37077, Göttingen, Germany
| | - Jens Frahm
- Biomedizinische NMR, Max-Planck-Institut für biophysikalische Chemie, 37077, Göttingen, Germany
| |
Collapse
|
14
|
Wada A, Tsuruta K, Irie R, Kamagata K, Maekawa T, Fujita S, Koshino S, Kumamaru K, Suzuki M, Nakanishi A, Hori M, Aoki S. Differentiating Alzheimer's Disease from Dementia with Lewy Bodies Using a Deep Learning Technique Based on Structural Brain Connectivity. Magn Reson Med Sci 2018; 18:219-224. [PMID: 30504639 PMCID: PMC6630050 DOI: 10.2463/mrms.mp.2018-0091] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) are representative disorders of dementia of the elderly and the neuroimaging has contributed to early diagnosis by estimation of alterations of brain volume, blood flow and metabolism. A brain network analysis by MR imaging (MR connectome) is a recently developed technique and can estimate the dysfunction of the brain network in AD and DLB. A graph theory which is a major technique of network analysis is useful for a group study to extract the feature of disorders, but is not necessarily suitable for the disorder differentiation at the individual level. In this investigation, we propose a deep learning technique as an alternative method of the graph analysis for recognition and classification of AD and DLB at the individual subject level. MATERIALS AND METHODS Forty-eight brain structural connectivity data of 18 AD, 8 DLB and 22 healthy controls were applied to the machine learning consisting of a six-layer convolution neural network (CNN) model. Estimation of the deep learning model to classify AD, DLB and non-AD/DLB was performed using the 4-fold cross-validation method. RESULTS The accuracy, average precision and recall of our CNN model were 0.73, 0.78 and 0.73, and the specificity precision and recall were 0.68 and 0.79 in AD, 0.94 and 0.65 in DLB and 0.73 and 0.75 in non-AD/DLB. The triangular probability map of the MR connectome revealed the probability of AD, DLB and non-AD/DLB in each subject. CONCLUSION Our preliminary investigation revealed the adaptation of deep learning to the MR connectome and proposed its utility in the differentiation of dementia disorders at the individual subject level.
Collapse
|
15
|
Mordechai S, Shufan E, Porat Katz BS, Salman A. Early diagnosis of Alzheimer's disease using infrared spectroscopy of isolated blood samples followed by multivariate analyses. Analyst 2018; 142:1276-1284. [PMID: 27827489 DOI: 10.1039/c6an01580h] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Alzheimer's disease (AD) is the most common cause of dementia, particularly in the elderly. The disease is characterized by cognitive decline that typically starts with insidious memory loss and progresses relentlessly to produce global impairment of all higher cortical functions. Due to better living conditions and health facilities in developed countries, which result in higher overall life spans, these countries report upward trends of AD among their populations. There are, however, no specific diagnostic tests for AD and clinical diagnosis is especially difficult in the earliest stages of the disease. Early diagnosis of AD is frequently subjective and is determined by physicians (generally neurologists, geriatricians, and psychiatrists) depending on their experience. Diagnosing AD requires both medical history and mental status testing. Having trouble with memory does not mean you have AD. AD has no current cure, but treatments for symptoms are available and research continues. In this study, we investigated the potential of infrared microscopy to differentiate between AD patients and controls, using Fourier transform infrared (FTIR) spectroscopy of isolated blood components. FTIR is known as a quick, safe, and minimally invasive method to investigate biological samples. For this goal, we measured infrared spectra from white blood cells (WBCs) and plasma taken from AD patients and controls, with the consent of the patients or their guardians. Applying multivariate analysis, principal component analysis (PCA) followed by linear discriminant analysis (LDA), it was possible to differentiate among the different types of mild, moderate, and severe AD, and the controls, with 85% accuracy when using the WBC spectra and about 77% when using the plasma spectra. When only the moderate and severe stages were included, an 83% accuracy was obtained using the WBC spectra and about 89% when using the plasma spectra.
Collapse
Affiliation(s)
- S Mordechai
- Department of Physics, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel.
| | | | | | | |
Collapse
|
16
|
Aytan N, Choi JK, Carreras I, Crabtree L, Nguyen B, Lehar M, Blusztajn JK, Jenkins BG, Dedeoglu A. Protective effects of 7,8-dihydroxyflavone on neuropathological and neurochemical changes in a mouse model of Alzheimer's disease. Eur J Pharmacol 2018; 828:9-17. [PMID: 29510124 DOI: 10.1016/j.ejphar.2018.02.045] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 02/13/2018] [Accepted: 02/28/2018] [Indexed: 12/26/2022]
Abstract
Interest in brain-derived neurotrophic factor (BDNF) was greatly enhanced when it was recognized that its expression is reduced in neurodegenerative disorders, especially in Alzheimer's disease (AD). BDNF signaling through the TrkB receptor has a central role in promoting synaptic transmission, synaptogenesis, and facilitating synaptic plasticity making the BDNF-TrkB signaling pathway an attractive candidate for targeted therapies. Here we investigated the early effect of the small molecule TrkB agonist, 7,8 dihydroxyflavone (7,8-DHF), on AD-related pathology, dendritic arborization, synaptic density, and neurochemical changes in the 5xFAD mouse model of AD. We treated 5xFAD mice with 7,8-DHF for 2 months beginning at 1 month of age. We found that, in this model of AD, 7,8-DHF treatment decreased cortical Aβ plaque deposition and protected cortical neurons against reduced dendritic arbor complexity but had no significant impact on the density of dendritic spines. In addition 7,8-DHF treatment protected against hippocampal increase in the level of choline-containing compounds and glutamate loss, but had no significant impact on hippocampal neurogenesis.
Collapse
Affiliation(s)
- Nurgul Aytan
- Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA 02130, USA; Department of Neurology Boston University School of Medicine, Boston, MA 02118, USA; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
| | - Ji-Kyung Choi
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
| | - Isabel Carreras
- Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA 02130, USA; Department of Biochemistry Boston University School of Medicine, Boston, MA 02118, USA.
| | - Leah Crabtree
- Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA 02130, USA; Department of Neurology Boston University School of Medicine, Boston, MA 02118, USA; University of Exeter Medical School, Devon EX4 4QJ, UK.
| | - Brian Nguyen
- Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA 02130, USA; Department of Neurology Boston University School of Medicine, Boston, MA 02118, USA.
| | - Margaret Lehar
- Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA 02130, USA; Department of Neurology Boston University School of Medicine, Boston, MA 02118, USA.
| | | | - Bruce G Jenkins
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
| | - Alpaslan Dedeoglu
- Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA 02130, USA; Department of Neurology Boston University School of Medicine, Boston, MA 02118, USA; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
| |
Collapse
|
17
|
Sheelakumari R, Sarma SP, Kesavadas C, Thomas B, Sasi D, Sarath LV, Justus S, Mathew M, Menon RN. Multimodality Neuroimaging in Mild Cognitive Impairment: A Cross-sectional Comparison Study. Ann Indian Acad Neurol 2018; 21:133-139. [PMID: 30122839 PMCID: PMC6073958 DOI: 10.4103/aian.aian_379_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background and Purpose Mild cognitive impairment (MCI) is a focus of considerable research. The present study aimed to test the utility of a logistic regression-derived classifier, combining specific quantitative multimodal magnetic resonance imaging (MRI) data for the early objective phenotyping of MCI in the clinic, over structural MRI data. Methods Thirty-three participants with cognitively stable amnestic MCI; 15 MCI converters to early Alzheimer's disease (AD; diseased controls) and 20 healthy controls underwent high-resolution T1-weighted volumetric MRI, diffusion tensor imaging (DTI), and proton magnetic resonance spectroscopy (1H MR spectroscopy). The regional volumes were obtained from T1-weighted MRI. The fractional anisotropy and mean diffusivity maps were derived from DTI over multiple white matter regions. The 1H MRS voxels were placed over posterior cingulate gyri, and N-acetyl aspartate (NAA)/creatine (Cr), choline (Cho)/Cr, myoinositol (mI/Cr), and NAA/mI ratios were obtained. A multimodal classifier comprising MR volumetry, DTI, and MRS was prepared. A cutoff point was arrived based on receiver operator characteristics analysis. Results were considered significant, if P < 0.05. Results The most sensitive individual marker to discriminate MCI from controls was DTI (90.9%), with a specificity of 50%. For classifying MCI from AD, the best individual modality was DTI (72.7%), with a high specificity of 87.9%. The multimodal classifier approach for MCI control classification achieved an area under curve (AUC) (AUC = 0.89; P < 0.001), with 93.9% sensitivity and 70% specificity. The combined classifier for MCI-AD achieved a highest AUC (AUC = 0.93; P < 0.001), with 93% sensitivity and 85.6% specificity. Conclusions The combined method of gray matter atrophy, white matter tract changes, and metabolite variation achieved a better performance at classifying MCI compared to the application of individual MRI biomarkers.
Collapse
Affiliation(s)
- R Sheelakumari
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.,Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Sankara P Sarma
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Chandrasekharan Kesavadas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Bejoy Thomas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Deepak Sasi
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Lekha V Sarath
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Sunitha Justus
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Mridula Mathew
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Ramshekhar N Menon
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| |
Collapse
|
18
|
Schreiner SJ, Kirchner T, Narkhede A, Wyss M, Van Bergen JMG, Steininger SC, Gietl A, Leh SE, Treyer V, Buck A, Pruessmann KP, Nitsch RM, Hock C, Henning A, Brickman AM, Unschuld PG. Brain amyloid burden and cerebrovascular disease are synergistically associated with neurometabolism in cognitively unimpaired older adults. Neurobiol Aging 2017; 63:152-161. [PMID: 29310864 DOI: 10.1016/j.neurobiolaging.2017.12.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/16/2017] [Accepted: 12/04/2017] [Indexed: 01/08/2023]
Abstract
Alzheimer's disease (AD) is the most common cause of cognitive dysfunction in older adults. The pathological hallmarks of AD such as beta amyloid (Aβ) aggregation and neurometabolic change, as indicated by altered myo-inositol (mI) and N-acetylaspartate (NAA) levels, typically precede the onset of cognitive dysfunction by years. Furthermore, cerebrovascular disease occurs early in AD, but the interplay between vascular and neurometabolic brain change is largely unknown. Thirty cognitively normal older adults (age = 70 ± 5.6 years, Mini-Mental State Examination = 29.2 ± 1) received 11-C-Pittsburgh Compound B positron emission tomography for estimating Aβ-plaque density, 7 Tesla fluid-attenuated inversion recovery magnetic resonance imaging for quantifying white matter hyperintensity volume as a marker of small vessel cerebrovascular disease and high-resolution magnetic resonance spectroscopic imaging at 7 Tesla, based on free induction decay acquisition localized by outer volume suppression to investigate tissue-specific neurometabolism in the posterior cingulate and precuneus. Aβ (β = 0.45, p = 0.018) and white matter hyperintensities (β = 0.40, p = 0.046) were independently and interactively (β = -0.49, p = 0.026) associated with a higher ratio of mI over NAA (mI/NAA) in the posterior cingulate and precuneus gray matter but not in the white matter. Our data suggest that cerebrovascular disease and Aβ burden are synergistically associated with AD-related gray matter neurometabolism in older adults.
Collapse
Affiliation(s)
- Simon J Schreiner
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Thomas Kirchner
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Atul Narkhede
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, NY
| | - Michael Wyss
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Jiri M G Van Bergen
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Stephanie C Steininger
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Anton Gietl
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Sandra E Leh
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Valerie Treyer
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Alfred Buck
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Klaas P Pruessmann
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Roger M Nitsch
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph Hock
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Anke Henning
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland; Max Planck Institute for Biological Cybernetics, Tubingen, Germany
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, NY.
| | - Paul G Unschuld
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| |
Collapse
|
19
|
de Wilde MC, Vellas B, Girault E, Yavuz AC, Sijben JW. Lower brain and blood nutrient status in Alzheimer's disease: Results from meta-analyses. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2017; 3:416-431. [PMID: 29067348 PMCID: PMC5651428 DOI: 10.1016/j.trci.2017.06.002] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Alzheimer's disease (AD) patients are at risk of nutritional insufficiencies because of physiological and psychological factors. Recently, we showed the results of the meta-analyses indicating lower plasma levels of vitamins A, B12, C, E, and folate in AD patients compared with cognitively intact elderly controls (controls). Now, additional and more extensive literature searches were performed selecting studies which compare blood and brain/cerebrospinal fluid (CSF) levels of vitamins, minerals, trace elements, micronutrients, and fatty acids in AD patients versus controls. METHODS The literature published after 1980 in Cochrane Central Register of Controlled Trials, Medline, and Embase electronic databases was systematically analyzed using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines to detect studies meeting the selection criteria. Search terms used are as follows: AD patients, Controls, vitamins, minerals, trace elements, micronutrients, and fatty acids. Random-effects meta-analyses using a linear mixed model with correction for age differences between AD patients and controls were performed when four or more publications were retrieved for a specific nutrient. RESULTS Random-effects meta-analyses of 116 selected publications showed significant lower CSF/brain levels of docosahexaenoic acid (DHA), choline-containing lipids, folate, vitamin B12, vitamin C, and vitamin E. In addition, AD patients showed lower circulatory levels of DHA, eicosapentaenoic acid, choline as phosphatidylcholine, and selenium. CONCLUSION The current data show that patients with AD have lower CSF/brain availability of DHA, choline, vitamin B12, folate, vitamin C, and vitamin E. Directionally, brain nutrient status appears to parallel the lower circulatory nutrient status; however, more studies are required measuring simultaneously circulatory and central nutrient status to obtain better insight in this observation. The brain is dependent on nutrient supply from the circulation, which in combination with nutrient involvement in AD-pathophysiological mechanisms suggests that patients with AD may have specific nutritional requirements. This hypothesis could be tested using a multicomponent nutritional intervention.
Collapse
Affiliation(s)
- Martijn C. de Wilde
- Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands
| | - Bruno Vellas
- Gerontopole and UMR INSERM 1027 University Paul Sabatier, Toulouse University Hospital, Toulouse, France
| | - Elodie Girault
- Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands
| | | | - John W. Sijben
- Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands
| |
Collapse
|
20
|
Sheikh-Bahaei N, Sajjadi SA, Manavaki R, Gillard JH. Imaging Biomarkers in Alzheimer's Disease: A Practical Guide for Clinicians. J Alzheimers Dis Rep 2017; 1:71-88. [PMID: 30480230 PMCID: PMC6159632 DOI: 10.3233/adr-170013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Although recent developments in imaging biomarkers have revolutionized the diagnosis of Alzheimer’s disease at early stages, the utility of most of these techniques in clinical setting remains unclear. The aim of this review is to provide a clear stepwise algorithm on using multitier imaging biomarkers for the diagnosis of Alzheimer’s disease to be used by clinicians and radiologists for day-to-day practice. We summarized the role of most common imaging techniques and their appropriate clinical use based on current consensus guidelines and recommendations with brief sections on acquisition and analysis techniques for each imaging modality. Structural imaging, preferably MRI or alternatively high resolution CT, is the essential first tier of imaging. It improves the accuracy of clinical diagnosis and excludes other potential pathologies. When the results of clinical examination and structural imaging, assessed by dementia expert, are still inconclusive, functional imaging can be used as a more advanced option. PET with ligands such as amyloid tracers and 18F-fluorodeoxyglucose can improve the sensitivity and specificity of diagnosis particularly at the early stages of the disease. There are, however, limitations in using these techniques in wider community due to a combination of lack of facilities and expertise to interpret the findings. The role of some of the more recent imaging techniques including tau imaging, functional MRI, or diffusion tensor imaging in clinical practice, remains to be established in the ongoing and future studies.
Collapse
Affiliation(s)
- Nasim Sheikh-Bahaei
- Department of Radiology, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | | | - Roido Manavaki
- Department of Radiology, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | | |
Collapse
|
21
|
Kim J, Choi IY, Duff KE, Lee P. Progressive Pathological Changes in Neurochemical Profile of the Hippocampus and Early Changes in the Olfactory Bulbs of Tau Transgenic Mice (rTg4510). Neurochem Res 2017; 42:1649-1660. [PMID: 28523532 DOI: 10.1007/s11064-017-2298-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 05/08/2017] [Accepted: 05/08/2017] [Indexed: 01/02/2023]
Abstract
Tauopathies such as Alzheimer's disease and frontotemporal lobe degeneration (FTLD-tau) dementia, characterized by pathologic aggregation of the microtubule-associated tau protein and formation of neurofibrillary tangles, have been linked to neurodegeneration and cognitive decline. The early detection of cerebral abnormalities and the identification of biological contributors to the continuous pathologic processes of neurodegeneration in tauopathies critically hinge on sensitive and reliable measures of biomarkers in the living brain. In this study, we measured alterations in a number of key neurochemicals associated with tauopathy-induced neurodegeneration in the hippocampus and the olfactory bulbs of a transgenic mouse model of FTLD-tauopathy, line rTg4510, using in vivo 1H magnetic resonance spectroscopy at 9.4 T. The rTg4510 line develops tauopathy at a young age (4-5 months), reaching a severe stage by 8-12 months of age. Longitudinal measurement of neurochemical concentrations in the hippocampus of mice from 5 to 12 months of age showed significant progressive changes with distinctive disease staging patterns including N-acetylaspartate, myo-inositol, γ-aminobutyric acid, glutathione and glutamine. The accompanying hippocampal volume loss measured using magnetic resonance imaging showed significant correlation (p < 0.01) with neurochemical measurements. Neurochemical alterations in the olfactory bulbs were more pronounced than those in the hippocampus in rTg4510 mice. These results demonstrate progressive neuropathology in the mouse model and provide potential biomarkers of early neuropathological events and effective noninvasive monitoring of the disease progression and treatment efficacy, which can be easily translated to clinical studies.
Collapse
Affiliation(s)
- Jieun Kim
- Hoglund Brain Imaging Center, University of Kansas Medical Center, 3901 Rainbow Blvd, Mail Stop 1052, Kansas City, KS, 66160, USA
| | - In-Young Choi
- Hoglund Brain Imaging Center, University of Kansas Medical Center, 3901 Rainbow Blvd, Mail Stop 1052, Kansas City, KS, 66160, USA.,Department of Neurology, University of Kansas Medical Center, Kansas City, KS, 66160, USA.,Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Karen E Duff
- Department of Integrative Neuroscience, Columbia University Medical Center, New York, NY, 10032, USA
| | - Phil Lee
- Hoglund Brain Imaging Center, University of Kansas Medical Center, 3901 Rainbow Blvd, Mail Stop 1052, Kansas City, KS, 66160, USA. .,Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, 66160, USA.
| |
Collapse
|
22
|
Heo H, Ahn JB, Lee HH, Kwon E, Yun JW, Kim H, Kang BC. Neurometabolic profiles of the substantia nigra and striatum of MPTP-intoxicated common marmosets: An in vivo proton MRS study at 9.4 T. NMR IN BIOMEDICINE 2017; 30:e3686. [PMID: 28028868 DOI: 10.1002/nbm.3686] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 11/16/2016] [Accepted: 11/22/2016] [Indexed: 06/06/2023]
Abstract
Given the strong coupling between the substantia nigra (SN) and striatum (STR) in the early stage of Parkinson's disease (PD), yet only a few studies reported to date that have simultaneously investigated the neurochemistry of these two brain regions in vivo, we performed longitudinal metabolic profiling in the SN and STR of 1-methyl-1,2,3,6-tetrahydropyridine (MPTP)-intoxicated common marmoset monkey models of PD (n = 10) by using proton MRS (1 H-MRS) at 9.4 T. T2 relaxometry was also performed in the SN by using MRI. Data were classified into control, MPTP_2weeks, and MPTP_6-10 weeks groups according to the treatment duration. In the SN, T2 of the MPTP_6-10 weeks group was lower than that of the control group (44.33 ± 1.75 versus 47.21 ± 2.47 ms, p < 0.05). The N-acetylaspartate to total creatine ratio (NAA/tCr) and γ-aminobutyric acid to tCr ratio (GABA/tCr) of the MPTP_6-10 weeks group were lower than those of the control group (0.41 ± 0.04 versus 0.54 ± 0.08 (p < 0.01) and 0.19 ± 0.03 versus 0.30 ± 0.09 (p < 0.05), respectively). The glutathione to tCr ratio (GSH/tCr) was correlated with T2 for the MPTP_6-10 weeks group (r = 0.83, p = 0.04). In the STR, however, GABA/tCr of the MPTP_6-10 weeks group was higher than that of the control group (0.25 ± 0.10 versus 0.16 ± 0.05, p < 0.05). These findings may be an in vivo depiction of the altered basal ganglion circuit in PD brain resulting from the degeneration of nigral dopaminergic neurons and disruption of nigrostriatal dopaminergic projections. Given the important role of non-human primates in translational studies, our findings provide better understanding of the complicated evolution of PD.
Collapse
Affiliation(s)
- Hwon Heo
- Department of Biomedical Sciences, Seoul National University, Seoul, South Korea
| | - Jae-Bum Ahn
- Department of Experimental Animal Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
- Graduate School of Translational Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyeong Hun Lee
- Department of Biomedical Sciences, Seoul National University, Seoul, South Korea
| | - Euna Kwon
- Department of Experimental Animal Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
| | - Jun-Won Yun
- Department of Experimental Animal Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
| | - Hyeonjin Kim
- Department of Biomedical Sciences, Seoul National University, Seoul, South Korea
- Department of Experimental Animal Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
- Department of Radiology, Seoul National University Hospital, Seoul, South Korea
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, South Korea
| | - Byeong-Cheol Kang
- Department of Experimental Animal Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
- Graduate School of Translational Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Designed Animal and Transplantation Research Institute, Institute of GreenBio Science and Technology, Seoul National University, Pyeongchang, South Korea
| |
Collapse
|
23
|
Ito T, Tanaka-Mizuno S, Iwashita N, Tooyama I, Shiino A, Miura K, Fukui S. Proton magnetic resonance spectroscopy assessment of metabolite status of the anterior cingulate cortex in chronic pain patients and healthy controls. J Pain Res 2017; 10:287-293. [PMID: 28203104 PMCID: PMC5293371 DOI: 10.2147/jpr.s123403] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background Chronic pain is a common cause of reduced quality of life. Recent studies suggest that chronic pain patients have a different brain neurometabolic status to healthy people. Proton magnetic resonance spectroscopy (1H-MRS) can determine the concentrations of metabolites in a specific region of the brain without being invasive. Patients and methods We recruited 56 chronic pain patients and 60 healthy controls to compare brain metabolic characteristics. The concentrations of glutamic acid (Glu), myo-inositol (Ins), N-acetylaspartate (NAA), Glu + glutamine (Glx), and creatine + phosphocreatine (total creatine [tCr]) in the anterior cingulate cortex of participants were measured using 1H-MRS. We used age- and gender-adjusted general linear models and receiver-operating characteristic analyses for this investigation. Patients were also assessed using the Hospital Anxiety and Depression Scale (HADS) to reveal the existence of any mental health issues. Results Our analysis indicates that pain patients have statistically significantly higher levels of Glu/tCr (p=0.039) and Glx/tCr (p<0.001) and lower levels of NAA/tCr than controls, although this did not reach statistical significance (p=0.052). Receiver-operating characteristic analysis performed on the combination of Glx/tCr, Ins/tCr, and NAA/tCr effectively discriminated chronic pain patients from healthy controls. Patients with higher HADS-Depression scores had increased Glx/rCr levels (p=0.015), and those with higher HADS-Anxiety scores had increased NAA/tCr levels (p=0.018). Conclusion Chronic pain patients have a different metabolite status in the anterior cingulate cortex to controls. Within the pain patient group, HADS scores had a positive relationship with NAA/tCr and Glx/tCr levels. 1H-MRS successfully detected metabolic changes in patients’ brains in a noninvasive manner, revealing its potential as a superior diagnostic tool for pain patients.
Collapse
Affiliation(s)
- Takahiro Ito
- Department of Public Health, Shiga University of Medical Science
| | - Sachiko Tanaka-Mizuno
- Department of Medical Statistics, Shiga University of Medical Science, Otsu, Japan; The Center for Data Science Education and Research, Shiga University, Hikone, Japan
| | - Narihito Iwashita
- Department of Anesthesiology, Interdisciplinary Pain Management Center, Shiga University of Medical Science Hospital
| | - Ikuo Tooyama
- Molecular Neuroscience Research Center, Shiga University of Medical Science
| | - Akihiko Shiino
- Biomedical MR Science Center, Shiga University of Medical Science
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Sei Fukui
- Department of Anesthesiology, Interdisciplinary Pain Management Center, Shiga University of Medical Science Hospital
| |
Collapse
|
24
|
Herminghaus S, Hertel A, Wittsack J, Gorriz C, Möller-Hartmann W, Fröhlich L, Dierks T, Lanfermann H, Zanella F. 99mTC-HMPAO-SPECT and Proton MR Spectroscopy in the Diagnosis of Alzheimer's Disease. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/19714009980110s210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - A. Hertel
- Dept. of Nuclear Medicine; University of Frankfurt; Germany
| | | | - C. Gorriz
- Clinic of Psychiatry; University of Frankfurt; Germany
| | | | - L. Fröhlich
- Clinic of Psychiatry; University of Frankfurt; Germany
| | - T. Dierks
- Clinic of Psychiatry; University of Frankfurt; Germany
| | | | | |
Collapse
|
25
|
Sanacora G, Rothman D, Krystal JH. Applications of Magnetic Resonance Spectroscopy to Psychiatry. Neuroscientist 2016. [DOI: 10.1177/107385849900500316] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The inaccessibility of the human brain to biochemical studies has historically challenged the ability of in vestigators to elucidate the pathophysiology of psychiatric syndromes. Magnetic resonance spectroscopy (MRS) now provides a noninvasive means of assessing neurochemistry in vivo. Since the first application of the technique to the study of the human brain, many new advances have been made. This new technology broadens the applications of the MRS. The major principles of the technique and compounds currently available for study are discussed in this article. A brief review of current and future applications of the technology to the field of psychiatry are discussed. NEUROSCIENTIST 5:192-196, 1999
Collapse
Affiliation(s)
- Gerard Sanacora
- Departments of Psychiatry and Internal Medicine Yale
University School of Medicine New Haven, Connecticut
| | - Douglas Rothman
- Departments of Psychiatry and Internal Medicine Yale
University School of Medicine New Haven, Connecticut
| | - John H. Krystal
- Departments of Psychiatry and Internal Medicine Yale
University School of Medicine New Haven, Connecticut
| |
Collapse
|
26
|
Lin AL, Powell D, Caban-Holt A, Jicha G, Robertson W, Gold BT, Davis R, Abner E, Wilcock DM, Schmitt FA, Head E. (1)H-MRS metabolites in adults with Down syndrome: Effects of dementia. NEUROIMAGE-CLINICAL 2016; 11:728-735. [PMID: 27330972 PMCID: PMC4908308 DOI: 10.1016/j.nicl.2016.06.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 04/11/2016] [Accepted: 06/01/2016] [Indexed: 02/04/2023]
Abstract
To determine if proton magnetic resonance spectroscopy (1H-MRS) detect differences in dementia status in adults with Down syndrome (DS), we used 1H-MRS to measure neuronal and glial metabolites in the posterior cingulate cortex in 22 adults with DS and in 15 age- and gender-matched healthy controls. We evaluated associations between 1H-MRS results and cognition among DS participants. Neuronal biomarkers, including N-acetylaspartate (NAA) and glutamate-glutamine complex (Glx), were significantly lower in DS patients with Alzheimer's should probably be changed to Alzheimer (without ' or s) through ms as per the new naming standard disease (DSAD) when compared to non-demented DS (DS) and healthy controls (CTL). Neuronal biomarkers therefore appear to reflect dementia status in DS. In contrast, all DS participants had significantly higher myo-inositol (MI), a putative glial biomarker, compared to CTL. Our data indicate that there may be an overall higher glial inflammatory component in DS compared to CTL prior to and possibly independent of developing dementia. When computing the NAA to MI ratio, we found that presence or absence of dementia could be distinguished in DS. NAA, Glx, and NAA/MI in all DS participants were correlated with scores from the Brief Praxis Test and the Severe Impairment Battery. 1H-MRS may be a useful diagnostic tool in future longitudinal studies to measure AD progression in persons with DS. In particular, NAA and the NAA/MI ratio is sensitive to the functional status of adults with DS, including prior to dementia. 1H-MRS was used to compare demented and nondemented adults with Down syndrome. Neuronal biomarkers were lowest in demented adults with Down syndrome. Glial biomarkers including myoinositol were higher in demented adults with DS. Neuronal and glial biomarkers were correlated with cognition in Down syndrome.
Collapse
Affiliation(s)
- A-L Lin
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA; Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - D Powell
- Magnetic Resonance Imaging and Spectroscopy Center, University of Kentucky, Lexington, KY, USA; Department of Anatomy and Neurobiology, University of Kentucky, Lexington, KY, USA
| | - A Caban-Holt
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA; Department of Neurology, University of Kentucky, Lexington, KY, USA
| | - G Jicha
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA; Department of Neurology, University of Kentucky, Lexington, KY, USA
| | - W Robertson
- Department of Neurology, University of Kentucky, Lexington, KY, USA
| | - B T Gold
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA; Magnetic Resonance Imaging and Spectroscopy Center, University of Kentucky, Lexington, KY, USA; Department of Anatomy and Neurobiology, University of Kentucky, Lexington, KY, USA
| | - R Davis
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - E Abner
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - D M Wilcock
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA; Department of Physiology, University of Kentucky, Lexington, KY, USA
| | - F A Schmitt
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA; Department of Neurology, University of Kentucky, Lexington, KY, USA
| | - E Head
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA; Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
27
|
Key concepts in MR spectroscopy and practical approaches to gaining biochemical information in children. Pediatr Radiol 2016; 46:941-51. [PMID: 27233787 DOI: 10.1007/s00247-014-3204-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 09/11/2014] [Accepted: 10/01/2014] [Indexed: 10/21/2022]
Abstract
Magnetic resonance spectroscopy (MRS) provides independent biochemical information and has become an invaluable adjunct to MRI and other imaging modalities. This review introduces key concepts and presents basic methodological steps regarding the acquisition and the interpretation of proton MRS. We review major brain metabolites and discuss MRS dependence on age, location, echo time and field strength.
Collapse
|
28
|
Ratai EM, Gilberto González R. Clinical magnetic resonance spectroscopy of the central nervous system. HANDBOOK OF CLINICAL NEUROLOGY 2016; 135:93-116. [PMID: 27432661 DOI: 10.1016/b978-0-444-53485-9.00005-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Proton magnetic resonance spectroscopy (1H MRS) is a noninvasive imaging technique that can easily be added to the conventional magnetic resonance (MR) imaging sequences. Using MRS one can directly compare spectra from pathologic or abnormal tissue and normal tissue. Metabolic changes arising from pathology that can be visualized by MRS may not be apparent from anatomy that can be visualized by conventional MR imaging. In addition, metabolic changes may precede anatomic changes. Thus, MRS is used for diagnostics, to observe disease progression, monitor therapeutic treatments, and to understand the pathogenesis of diseases. MRS may have an important impact on patient management. The purpose of this chapter is to provide practical guidance in the clinical application of MRS of the brain. This chapter provides an overview of MRS-detectable metabolites and their significance. In addition some specific current clinical applications of MRS will be discussed, including brain tumors, inborn errors of metabolism, leukodystrophies, ischemia, epilepsy, and neurodegenerative diseases. The chapter concludes with technical considerations and challenges of clinical MRS.
Collapse
Affiliation(s)
- Eva-Maria Ratai
- Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, and Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA.
| | - R Gilberto González
- Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, and Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA
| |
Collapse
|
29
|
Tiwari V, Solanki V, Tiwari M. In-vivoandin-vitrotechniques used to investigate Alzheimer's disease. FRONTIERS IN LIFE SCIENCE 2015. [DOI: 10.1080/21553769.2015.1044129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
30
|
Choi JK, Carreras I, Aytan N, Jenkins-Sahlin E, Dedeoglu A, Jenkins BG. The effects of aging, housing and ibuprofen treatment on brain neurochemistry in a triple transgene Alzheimer's disease mouse model using magnetic resonance spectroscopy and imaging. Brain Res 2014; 1590:85-96. [PMID: 25301691 DOI: 10.1016/j.brainres.2014.09.067] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 09/09/2014] [Accepted: 09/27/2014] [Indexed: 01/18/2023]
Abstract
We investigated a triple transgene Alzheimer's disease (AD) mouse model that recapitulates many of the neurochemical, anatomic, pathologic and behavioral defects seen in human AD. We studied the mice as a function of age and brain region and investigated potential therapy with the non-steroidal anti-inflammatory drug ibuprofen. Magnetic resonance spectroscopy (MRS) showed alterations characteristic of AD (i.e. increased myo-inositol and decreased N-acetylaspartate (NAA)). Mice at 6 months of age showed an increase in myo-inositol in the hippocampus at a time when the Aβ is intracellular, but not in amygdala or cortex. Myo-inositol increased as a function of age in the amygdala, cortex and striatum while NAA decreased only in the hippocampus and cortex at 17-23 months of age. Ibuprofen protected the increase of myo-inositol at six months of age in the hippocampus, but had no effect at 17-23 months of age (a time when Aβ is extracellular). In vivo MRI and MRS showed that at 17-23 months of age there was a significant protective effect of ibuprofen on hippocampal volume and NAA loss. Together, these data show the following: the increase in myo-inositol occurs before the decrease in NAA in hippocampus but not cortex; the hippocampus shows earlier changes than does the amygdale or cortex consistent with earlier deposition of Aβ40-42 in the hippocampus and ibuprofen protects against multiple components of the AD pathology. These data also show a profound effect of housing on this particular mouse model.
Collapse
Affiliation(s)
- Ji-Kyung Choi
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
| | - Isabel Carreras
- Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA 02130, USA; Department of Biochemistry, Boston University School of Medicine, Boston, MA, USA
| | - Nur Aytan
- Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA 02130, USA; Neurology and Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA
| | - Eric Jenkins-Sahlin
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Alpaslan Dedeoglu
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA 02130, USA; Neurology and Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA
| | - Bruce G Jenkins
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
| |
Collapse
|
31
|
Tunc-Skarka N, Meier S, Demirakca T, Sack M, Weber-Fahr W, Brusniak W, Wolf I, Matthäus F, Schulze TG, Diener C, Ende G. Effects of normal aging and SCN1A risk-gene expression on brain metabolites: evidence for an association between SCN1A and myo-inositol. NMR IN BIOMEDICINE 2014; 27:228-234. [PMID: 24357141 DOI: 10.1002/nbm.3057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 10/29/2013] [Accepted: 11/04/2013] [Indexed: 06/03/2023]
Abstract
Previously reported MRS findings in the aging brain include lower N-acetylaspartate (NAA) and higher myo-inositol (mI), total creatine (Cr) and choline-containing compound (Cho) concentrations. Alterations in the sodium channel voltage gated type I, alpha subunit SCN1A variant rs10930201 have been reported to be associated with several neurological disorders with cognitive deficits. MRS studies in SCN1A-related diseases have reported striking differences in the mI concentrations between patients and controls. In a study on 'healthy aging', we investigated metabolite spectra in a sample of 83 healthy volunteers and determined their age dependence. We also investigated a potential link between SCN1A and mI. We observed a significantly negative association of NAA (p = 0.004) and significantly positive associations of mI (p ≤ 0.001), Cr (p ≤ 0.001) and Cho (p = 0.034) with age in frontal white matter. The linear association of Cho ends at the age of about 50 years and is followed by an inverted 'U'-shaped curve. Further, mI was higher in C allele carriers of the SCN1A variant rs10930201. Our results corroborated the age-related changes in metabolite concentrations, and found evidence for a link between SCN1A and frontal white matter mI in healthy subjects.
Collapse
Affiliation(s)
- Nuran Tunc-Skarka
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty of Mannheim/Heidelberg University, Germany
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Doyle-Thomas KA, Card D, Soorya LV, Wang AT, Fan J, Anagnostou E. Metabolic mapping of deep brain structures and associations with symptomatology in autism spectrum disorders. RESEARCH IN AUTISM SPECTRUM DISORDERS 2014; 8:44-51. [PMID: 24459534 PMCID: PMC3897261 DOI: 10.1016/j.rasd.2013.10.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Structural neuroimaging studies in autism report atypical volume in deep brain structures which are related to symptomatology. Little is known about metabolic changes in these regions, and how they vary with age and sex, and/or relate to clinical behaviors. Using magnetic resonance spectroscopy we measured N-acetylaspartate, choline, creatine, myoinositol and glutamate in the caudate, putamen, and thalamus of 20 children with autism and 16 typically developing controls (7-18 years). Relative to controls, individuals with autism had elevated glutamate/creatine in the putamen. In addition, both groups showed age-related increases in glutamate in this region. Boys, relative to girls had increased choline/creatine in the thalamus. Lastly, there were correlations between glutamate, choline, and myoinositol in all three regions, and behavioral scores in the ASD group. These findings suggest changes in deep gray matter neurochemistry, which are sensitive to diagnosis, age and sex, and are associated with behavioral differences.
Collapse
Affiliation(s)
- Krissy A.R. Doyle-Thomas
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, 150 Kilgour Road, Toronto, Ontario, Canada M4G 1R8
| | - Dallas Card
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Canada M5G 1X8
- Neurosciences & Mental Health Program, Research Institute, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Canada M5G 1X8
| | - Latha V. Soorya
- Departments of Psychiatry and Neuroscience, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, New York, NY 10029-6574, USA
| | - A. Ting Wang
- Departments of Psychiatry and Neuroscience, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, New York, NY 10029-6574, USA
| | - Jin Fan
- Departments of Psychiatry and Neuroscience, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, New York, NY 10029-6574, USA
- Department of Psychology, Queens College, City University of New York, 65-30 Kissena Boulevard, Queens, NY 11367-1597, USA
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, 150 Kilgour Road, Toronto, Ontario, Canada M4G 1R8
| |
Collapse
|
33
|
Fukui S, Shigemori S, Nosaka S. Evaluation of thalamic neural function in chronic neuropathic pain patients by proton MR spectroscopy: a correlative study with rCBF by SPECT. ACTA ACUST UNITED AC 2013. [DOI: 10.1163/156856902760196397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
34
|
R-flurbiprofen improves tau, but not Aß pathology in a triple transgenic model of Alzheimer's disease. Brain Res 2013; 1541:115-27. [PMID: 24161403 DOI: 10.1016/j.brainres.2013.10.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 10/10/2013] [Accepted: 10/15/2013] [Indexed: 11/24/2022]
Abstract
We have previously reported that chronic ibuprofen treatment improves cognition and decreases intracellular Aß and phosphorylated-tau levels in 3xTg-AD mice. Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that independently of its anti-inflammatory effects has anti-amyloidogenic activity as a gamma-secretase modulator (GSM) and both activities have the potential to decrease Aß pathology. To further understand the effects of NSAIDs in 3xTg-AD mice, we treated 3xTg-AD mice with R-flurbiprofen, an enantiomer of the NSAID flurbiprofen that maintains the GSM activity but has greatly reduced anti-inflammatory activity, and analyzed its effect on cognition, Aß, tau, and the neurochemical profile of the hippocampus. Treatment with R-flurbiprofen from 5 to 7 months of age resulted in improved cognition on the radial arm water maze (RAWM) test and decreased the level of hyperphosphorylated tau immunostained with AT8 and PHF-1 antibodies. No significant changes in the level of Aß (using 6E10 and NU-1 antibodies) were detected. Using magnetic resonance spectroscopy (MRS) we found that R-flurbiprofen treatment decreased the elevated level of glutamine in 3xTg-AD mice down to the level detected in non-transgenic mice. Glutamine levels correlated with PHF-1 immunostained hyperphosphorylated tau. We also found an inverse correlation between the concentration of glutamate and learning across all the mice in the study. Glutamine and glutamate, neurochemicals that shuttles between neurons and astrocytes to maintain glutamate homeostasis in the synapses, deserve further attention as MR markers of cognitive function.
Collapse
|
35
|
Kantarci K. Proton MRS in mild cognitive impairment. J Magn Reson Imaging 2013; 37:770-7. [PMID: 23526756 DOI: 10.1002/jmri.23800] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 08/03/2012] [Indexed: 11/08/2022] Open
Abstract
Mild cognitive impairment (MCI) is a clinical syndrome operationalized for early diagnosis and treatment of Alzheimer's disease (AD). Many individuals with MCI are at the prodromal stage of AD or other dementia. Various quantitative magnetic resonance imaging (MRI) techniques that measure the anatomic, biochemical, microstructural, functional, and blood-flow changes are being evaluated as possible surrogate measures for early diagnosis and disease progression in MCI. The pathology underlying MCI is heterogeneous, dominated by AD, cerebrovascular disease, Lewy body disease, or a mixture of these pathologies in autopsy cohorts. Proton magnetic resonance spectroscopy ((1)H MRS) metabolite markers may help identify and track etiologies that typically underlie MCI in the elderly. The role of proton MRS will be critical for pathophysiological processes for which a reliable biomarker does not exist such as neuronal dysfunction, glial and microglial activation in MCI.
Collapse
Affiliation(s)
- Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA.
| |
Collapse
|
36
|
Fukui S, Shigemori S, Nosaka S. A case of central post-stroke pain with beneficial response to electroconvulsive therapy: a proton magnetic resonance spectroscopy study. ACTA ACUST UNITED AC 2013. [DOI: 10.1163/156856902760196405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
37
|
Fukui S, Nosaka S. Proton magnetic resonance spectroscopy of the thalamus in chronic complex regional pain syndrome (CRPS) type-1 patients. ACTA ACUST UNITED AC 2013. [DOI: 10.1163/15685690260494915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
38
|
Alzheimer's disease biomarkers: correspondence between human studies and animal models. Neurobiol Dis 2013; 56:116-30. [PMID: 23631871 DOI: 10.1016/j.nbd.2013.04.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 04/11/2013] [Accepted: 04/18/2013] [Indexed: 01/05/2023] Open
Abstract
Alzheimer's disease (AD) represents an escalating global threat as life expectancy and disease prevalence continue to increase. There is a considerable need for earlier diagnoses to improve clinical outcomes. Fluid biomarkers measured from cerebrospinal fluid (CSF) and blood, or imaging biomarkers have considerable potential to assist in the diagnosis and management of AD. An additional important utility of biomarkers is in novel therapeutic development and clinical trials to assess efficacy and side effects of therapeutic interventions. Because many biomarkers are initially examined in animal models, the extent to which markers translate from animals to humans is an important issue. The current review highlights many existing and pipeline biomarker approaches, focusing on the degree of correspondence between AD patients and animal models. The review also highlights the need for greater translational correspondence between human and animal biomarkers.
Collapse
|
39
|
Forster D, Davies K, Williams S. Magnetic resonance spectroscopy in vivo of neurochemicals in a transgenic model of Alzheimer's disease: a longitudinal study of metabolites, relaxation time, and behavioral analysis in TASTPM and wild-type mice. Magn Reson Med 2013; 69:944-55. [PMID: 22760762 DOI: 10.1002/mrm.24349] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Revised: 04/30/2012] [Accepted: 05/03/2012] [Indexed: 11/09/2022]
Abstract
Alzheimer's disease (AD) is the most common form of dementia in the elderly. Due to ongoing advances in our understanding of the underlying pathology of AD, many potential new targets for therapeutics are becoming available. Transgenic mouse models of AD have helped in furthering our understanding of AD and also provide a vehicle for preclinical testing of new, putative disease-modifying therapeutics, which may have potential for translation to use in clinical trials. To identify possible translational biomarkers, we have studied the longitudinal cerebral metabolic pattern of the TASTPM transgenic AD mouse, a double transgenic mouse overexpressing human mutant amyloid precursor protein (hAPP695swe) and presenilin-1 (M146V) by (1) H magnetic resonance spectroscopy, along with concurrent brain T1 /T2 mapping and behavioral testing. We found significant differences in creatine, glutamate, N-acetylaspartate, choline-containing compounds, and myo-inositol between TASTPM and wild-type mice. In the case of N-acetylaspartate and myo-inositol, there were similarities to differences detected in human AD. T1 /T2 values were shorter overall in TASTPM mice, indicating possible differences in water content between TASTPM and wild-type mice. In older TASTPM mice, exploratory behavior became more random, indicating a possible memory deficiency. The decrease in behavioral performance correlated in the transgenic group with higher expression of myo-inositol.
Collapse
Affiliation(s)
- Duncan Forster
- Center for Imaging Science, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom.
| | | | | |
Collapse
|
40
|
Sun J, Beger RD, Schnackenberg LK. Metabolomics as a tool for personalizing medicine: 2012 update. Per Med 2013; 10:149-161. [DOI: 10.2217/pme.13.8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Numerous factors in conjunction with an individual’s genetic make up will determine predisposition to disease, adverse or beneficial effects of drug treatment or therapy, and disease progression. A major limitation of current clinical measures is that the disease phenotype, which is comprised of the genotype and other environmental factors, is underestimated. Rather, each disease is treated similarly even though the disease process is highly complex. Methods that evaluate the interaction of genotype and environmental factors would likely be a better indicator of patients’ response to medical treatments. The omics technologies, specifically metabolomics, will play a major role in the movement towards personalized medicine. Metabolomics is phenotype driven and should provide better clinical biomarkers. Furthermore, recent studies have shown that associations between genetic variants and downstream metabolite changes can provide a unique description of an individual’s genotype and phenotype, which will further enhance the movement towards personalized medicine.
Collapse
Affiliation(s)
- Jinchun Sun
- Division of Systems Biology, National Center for Toxicological Research, US FDA, 3900 NCTR Road, Jefferson, AR 72079, USA
| | - Richard D Beger
- Division of Systems Biology, National Center for Toxicological Research, US FDA, 3900 NCTR Road, Jefferson, AR 72079, USA
| | - Laura K Schnackenberg
- Division of Systems Biology, National Center for Toxicological Research, US FDA, 3900 NCTR Road, Jefferson, AR 72079, USA
| |
Collapse
|
41
|
Nie K, Zhang Y, Huang B, Wang L, Zhao J, Huang Z, Gan R, Wang L. Marked N-acetylaspartate and choline metabolite changes in Parkinson's disease patients with mild cognitive impairment. Parkinsonism Relat Disord 2013; 19:329-34. [DOI: 10.1016/j.parkreldis.2012.11.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Revised: 11/15/2012] [Accepted: 11/22/2012] [Indexed: 11/30/2022]
|
42
|
Abstract
Neurodegenerative dementias are characterized by elevated myoinositol and decreased N-acetylaspartate (NAA) levels. The increase in myoinositol seems to precede decreasing NAA levels in Alzheimer's diseases. NAA/myo-inositol ratio in the posterior cingulate gyri decreases with increasing burden of Alzheimer's disease pathologic conditions. Proton magnetic resonance spectroscopy ((1)H MRS) is sensitive to the pathophysiologic processes associated with the risk of dementia in patients with mild cognitive impairment. Although significant progress has been made in improving the acquisition and analysis techniques in (1)H MRS, translation of these technical developments to clinical practice have not been effective because of the lack of standardization for multisite applications and normative data and an insufficient understanding of the pathologic basis of (1)H MRS metabolite changes.
Collapse
|
43
|
Abstract
Aging is the primary risk factor for dementia. With increasing life expectancy and aging populations worldwide, dementia is becoming one of the significant public health problems of the century. The most common pathology underlying dementia in older adults is Alzheimer's disease. Proton magnetic resonance spectroscopy (MRS) may provide a window into the biochemical changes associated with the loss of neuronal integrity and other neurodegenerative pathology that involve the brain before the manifestations of cognitive impairment in patients who are at risk for Alzheimer's disease. This review focuses on proton MRS studies in normal aging, mild cognitive impairment, and dementia, and how proton MRS metabolite levels may be potential biomarkers for early diagnosis of dementia-related pathologic changes in the brain.
Collapse
|
44
|
Román G, Pascual B. Contribution of Neuroimaging to the Diagnosis of Alzheimer’s Disease and Vascular Dementia. Arch Med Res 2012; 43:671-6. [DOI: 10.1016/j.arcmed.2012.10.018] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 10/25/2012] [Indexed: 01/05/2023]
|
45
|
Jack CR. Alzheimer disease: new concepts on its neurobiology and the clinical role imaging will play. Radiology 2012; 263:344-61. [PMID: 22517954 DOI: 10.1148/radiol.12110433] [Citation(s) in RCA: 150] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Alzheimer disease (AD) is one of, if not the most, feared diseases associated with aging. The prevalence of AD increases exponentially with age after 60 years. Increasing life expectancy coupled with the absence of any approved disease-modifying therapies at present position AD as a dominant public health problem. Major advances have occurred in the development of disease biomarkers for AD in the past 2 decades. At present, the most well-developed AD biomarkers are the cerebrospinal fluid analytes amyloid-β 42 and tau and the brain imaging measures amyloid positron emission tomography (PET), fluorodeoxyglucose PET, and magnetic resonance imaging. CSF and imaging biomarkers are incorporated into revised diagnostic guidelines for AD, which have recently been updated for the first time since their original formulation in 1984. Results of recent studies suggest the possibility of an ordered evolution of AD biomarker abnormalities that can be used to stage the typical 20-30-year course of the disease. When compared with biomarkers in other areas of medicine, however, the absence of standardized quantitative metrics for AD imaging biomarkers constitutes a major deficiency. Failure to move toward a standardized system of quantitative metrics has substantially limited potential diagnostic usefulness of imaging in AD. This presents an important opportunity that, if widely embraced, could greatly expand the application of imaging to improve clinical diagnosis and the quality and efficiency of clinical trials.
Collapse
Affiliation(s)
- Clifford R Jack
- Department of Radiology, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
| |
Collapse
|
46
|
Silveira de Souza A, de Oliveira-Souza R, Moll J, Tovar-Moll F, Andreiuolo PA, Bottino CMC. Contribution of 1H spectroscopy to a brief cognitive-functional test battery for the diagnosis of mild Alzheimer's disease. Dement Geriatr Cogn Disord 2012; 32:351-61. [PMID: 22311276 DOI: 10.1159/000334656] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/21/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS 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. CONCLUSION 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.
Collapse
|
47
|
Elevated serum C-reactive protein relates to increased cerebral myoinositol levels in middle-aged adults. Cardiovasc Psychiatry Neurol 2012; 2012:120540. [PMID: 22461977 PMCID: PMC3296271 DOI: 10.1155/2012/120540] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Revised: 01/04/2012] [Accepted: 01/12/2012] [Indexed: 01/08/2023] Open
Abstract
C-reactive protein (CRP), a systemic marker of inflammation, is a risk factor for late life cognitive impairment and dementia, yet the mechanisms that link elevated CRP to cognitive decline are not fully understood. In this study we examined the relationship between CRP and markers of neuronal integrity and cerebral metabolism in middle-aged adults with intact cognitive function, using proton magnetic resonance spectrocospy. We hypothesized that increased levels of circulating CRP would correlate with changes in brain metabolites indicative of early brain vulnerability. Thirty-six individuals, aged 40 to 60, underwent neuropsychological assessment, a blood draw for CRP quantification, and 1H MRS examining N-acetyl-aspartate, myo-inositol, creatine, choline, and glutamate concentrations in occipito-parietal grey matter. Independent of age, sex and education, serum CRP was significantly related to higher cerebral myo-inositol/creatine ratio (F(4,31) = 4.74, P = 0.004), a relationship which remained unchanged after adjustment for cardiovascular risk (F(5,30) = 4.356, CRP β = 0.322, P = 0.045). Because these biomarkers are detectable in midlife they may serve as useful indicators of brain vulnerability during the preclinical period when mitigating intervention is still possible.
Collapse
|
48
|
Shigemura T, Kishida S, Eguchi Y, Ohtori S, Nakamura J, Kojima M, Masuda Y, Takahashi K. Proton magnetic resonance spectroscopy of the thalamus in patients with osteoarthritis of the hip. Bone Joint Res 2012; 1:8-12. [PMID: 23610652 PMCID: PMC3626186 DOI: 10.1302/2046-3758.11.2000018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 12/16/2011] [Indexed: 11/22/2022] Open
Abstract
Objectives The purpose of this study was to assess N-acetyl aspartate changes
in the thalamus in patients with osteoarthritis of the hip using
proton magnetic resonance spectroscopy. Methods Nine patients with osteoarthritis of the hip (symptomatic group,
nine women; mean age 61.4 years (48 to 78)) and nine healthy volunteers
(control group, six men, three women; mean age 30.0 years (26 to
38)) underwent proton magnetic resonance spectroscopy to assess
the changes of N-acetyl aspartate in the thalamus. Results The ratio of N-acetyl aspartate to creatine plus phosphocreatine
in the thalamus contralateral to the symptomatic hip in patients
with osteoarthritis of the hip was significantly lower than the
ratio of N-acetyl aspartate to creatine plus phosphocreatine in the
thalamus in the control group (1.611 (range; 1.194-1.882) vs 1.355
(range; 1.043-1.502), p < 0.001). And, a strong negative correlation
was detected between the ratio of N-acetyl aspartate to creatine
plus phosphocreatine in the thalamus contralateral to the symptomatic
hip in patients with osteoarthritis of the hip and pain duration
(r = -0.83, p = 0.018). Conclusions We evaluated the ratio of N-acetyl aspartate to creatine plus
phosphocreatine in the thalamus of patients with osteoarthritis
of the hip by using proton magnetic resonance spectroscopy. We concluded
that the ratio of N-acetyl aspartate to creatine plus phosphocreatine
in the thalamus contralateral to the symptomatic hip in patients
with osteoarthritis of the hip were significantly lower than those
in the thalamus of the control group, and that pain duration was
strongly related to the decrease of the ratio of N-acetyl aspartate
to creatine plus phosphocreatine.
Collapse
Affiliation(s)
- T Shigemura
- Graduate School of Medicine, Chiba University, Department of Orthopaedic Surgery, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Forster DM, James MF, Williams SR. Effects of Alzheimer's disease transgenes on neurochemical expression in the mouse brain determined by ¹H MRS in vitro. NMR IN BIOMEDICINE 2012; 25:52-58. [PMID: 22241671 DOI: 10.1002/nbm.1712] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 02/17/2011] [Accepted: 02/17/2011] [Indexed: 05/31/2023]
Abstract
Transgenic models of human disease can be used to understand pathology and to discover biomarkers of disease presence, progression and response to therapy. Here we report a study of longitudinal metabolic differences between TASTPM transgenic Alzheimer's disease (AD) mice and their wild type counterparts using (1)H magnetic resonance spectroscopy (MRS) to look for potential biomarkers for use in AD research and drug discovery. Chloroform methanol extractions were performed on the brains of mice aged between 3 and 18 months. (1)H MR spectra were recorded from the aqueous fractions. Absolute metabolite concentrations, determined from resonance integrals relative to an internal standard, were analysed by 2-way ANOVA (genotype x age). Significant effects of age alone were identified for creatine, glutamine and total choline-containing compounds. There was a marked increase in creatine in the oldest (15-18 mo) TASTPM mice. The increase in creatine was unexpected and may be caused by osmotic stress in older animals as plaque load increases. Care should be taken when using creatine as a reference metabolite during scans of these animals in vivo. A significant effect of genotype alone was identified for myo-inositol (MI), which was higher in TASTPM mice at all ages. Succinate, glycerophosphocholine and choline all showed significant effects of age and genotype. No significant effects were detected in N-acetylaspartate (NAA) levels. Increased MI could be a marker of gliosis or microglial activation in TASTPM mice, but the absence of an age dependence for MI levels means it may be a biomarker of disease, but not of disease progression. Decreased succinate is indicative of disrupted neuronal energy metabolism, an effect that has been seen in human AD.
Collapse
|
50
|
Shigemura T, Kishida S, Eguchi Y, Ohtori S, Nakamura J, Kojima M, Masuda Y, Takahashi K. Proton magnetic resonance spectroscopy of the thalamus in patients with osteoarthritis of the hip. Bone Joint Res 2012. [DOI: 10.1302/2046-3758.1.1.2000018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives The purpose of this study was to assess N-acetyl aspartate changes in the thalamus in patients with osteoarthritis of the hip using proton magnetic resonance spectroscopy. Methods Nine patients with osteoarthritis of the hip (symptomatic group, nine women; mean age 61.4 years (48 to 78)) and nine healthy volunteers (control group, six men, three women; mean age 30.0 years (26 to 38)) underwent proton magnetic resonance spectroscopy to assess the changes of N-acetyl aspartate in the thalamus. Results The ratio of N-acetyl aspartate to creatine plus phosphocreatine in the thalamus contralateral to the symptomatic hip in patients with osteoarthritis of the hip was significantly lower than the ratio of N-acetyl aspartate to creatine plus phosphocreatine in the thalamus in the control group (1.611 (1.194 to 1.882) vs 1.355 (1.043 to 1.502), p < 0.001). And, a strong negative correlation was detected between the ratio of N-acetyl aspartate to creatine plus phosphocreatine in the thalamus contralateral to the symptomatic hip in patients with osteoarthritis of the hip and pain duration (r = -0.83, p = 0.018). Conclusions We evaluated the ratio of N-acetyl aspartate to creatine plus phosphocreatine in the thalamus of patients with osteoarthritis of the hip by using proton magnetic resonance spectroscopy. We concluded that the ratio of N-acetyl aspartate to creatine plus phosphocreatine in the thalamus contralateral to the symptomatic hip in patients with osteoarthritis of the hip were significantly lower than those in the thalamus of the control group, and that pain duration was strongly related to the decrease of the ratio of N-acetyl aspartate to creatine plus phosphocreatine.
Collapse
Affiliation(s)
- T. Shigemura
- Graduate School of Medicine, Chiba University, Department
of Orthopaedic Surgery, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - S. Kishida
- Graduate School of Medicine, Chiba University, Department
of Orthopaedic Surgery, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Y. Eguchi
- Matsudo City Hospital, 4005
Kamihongo, Matsudo, 271-8511, Japan
| | - S. Ohtori
- Graduate School of Medicine, Chiba University, Department
of Orthopaedic Surgery, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - J. Nakamura
- Graduate School of Medicine, Chiba University, Department
of Orthopaedic Surgery, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - M. Kojima
- Chiba University Hospital, Department
of Radiology, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Y. Masuda
- Chiba University Hospital, Department
of Radiology, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - K. Takahashi
- Graduate School of Medicine, Chiba University, Department
of Orthopaedic Surgery, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| |
Collapse
|