1
|
Mitochondrial dysfunction, oxidative stress, neuroinflammation, and metabolic alterations in the progression of Alzheimer's disease: A meta-analysis of in vivo magnetic resonance spectroscopy studies. Ageing Res Rev 2021; 72:101503. [PMID: 34751136 DOI: 10.1016/j.arr.2021.101503] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 10/19/2021] [Accepted: 10/25/2021] [Indexed: 12/13/2022]
Abstract
Accumulating evidence demonstrates that metabolic changes in the brain associated with neuroinflammation, oxidative stress, and mitochondrial dysfunction play an important role in the pathophysiology of mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, the neural signatures associated with these metabolic alterations and underlying molecular mechanisms are still elusive. Accordingly, we reviewed the literature on in vivo human brain 1H and 31P-MRS studies and use meta-analyses to identify patterns of brain metabolic alterations in MCI and AD. 40 and 39 studies on MCI and AD, respectively, were classified according to brain regions. Our results indicate decreased N-acetyl aspartate and creatine but increased myo-inositol levels in both MCI and AD, decreased glutathione level in MCI as well as disrupted energy metabolism in AD. In addition, the hippocampus shows the strongest alterations in most of these metabolites. This meta-analysis also illustrates progressive metabolite alterations from MCI to AD. Taken together, it suggests that 1) neuroinflammation and oxidative stress may occur in the early stages of AD, and likely precede neuron loss in its progression; 2) the hippocampus is a sensitive region of interest for early diagnosis and monitoring the response of interventions; 3) targeting bioenergetics associated with neuroinflammation/oxidative stress is a promising approach for treating AD.
Collapse
|
2
|
Liu H, Zhang D, Lin H, Zhang Q, Zheng L, Zheng Y, Yin X, Li Z, Liang S, Huang S. Meta-Analysis of Neurochemical Changes Estimated via Magnetic Resonance Spectroscopy in Mild Cognitive Impairment and Alzheimer's Disease. Front Aging Neurosci 2021; 13:738971. [PMID: 34744689 PMCID: PMC8569809 DOI: 10.3389/fnagi.2021.738971] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/26/2021] [Indexed: 11/18/2022] Open
Abstract
The changes of neurochemicals in mild cognitive impairment (MCI) and Alzheimer's disease (AD) patients has been observed via magnetic resonance spectroscopy in several studies. However, whether it exists the consistent pattern of changes of neurochemicals in the encephalic region during the progression of MCI to AD were still not clear. The study performed meta-analysis to investigate the patterns of neurochemical changes in the encephalic region in the progress of AD. We searched the PubMed, Embase, Cochrane Library, and Web of Science databases, and finally included 63 studies comprising 1,086 MCI patients, 1,256 AD patients, and 1,907 healthy controls. It showed that during the progression from MCI to AD, N-acetyl aspartate (NAA) decreased continuously in the posterior cingulate (PC) (SMD: −0.42 [95% CI: −0.62 to −0.21], z = −3.89, P < 0.05), NAA/Cr (creatine) was consistently reduced in PC (SMD: −0.58 [95% CI: −0.86 to −0.30], z = −4.06, P < 0.05) and hippocampus (SMD: −0.65 [95% CI: −1.11 to −0.12], z = −2.44, P < 0.05), while myo-inositol (mI) (SMD: 0.44 [95% CI: 0.26–0.61], z = 4.97, P < 0.05) and mI/Cr (SMD: 0.43 [95% CI: 0.17–0.68], z = 3.30, P < 0.05) were raised in PC. Furthermore, these results were further verified by a sustained decrease in the NAA/mI of PC (SMD: −0.94 [95% CI: −1.24 to −0.65], z = −6.26, P < 0.05). Therefore, the levels of NAA and mI were associated with the cognitive decline and might be used as potentially biomarkers to predict the possible progression from MCI to AD. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020200308.
Collapse
Affiliation(s)
- Huanhuan Liu
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Rehabilitation Industry Institute, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Dandan Zhang
- College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Huawei Lin
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Rehabilitation Industry Institute, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Qi Zhang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Ling Zheng
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yuxin Zheng
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiaolong Yin
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Rehabilitation Industry Institute, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Zuanfang Li
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, China
| | - Shengxiang Liang
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Rehabilitation Industry Institute, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Traditional Chinese Medicine Rehabilitation Research Center of State Administration of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Saie Huang
- Department of Neurological Rehabilitation, Fujian University of Traditional Chinese Medicine Subsidiary Rehabilitation Hospital, Fuzhou, China
| |
Collapse
|
3
|
Zhang YD, Dong Z, Wang SH, Yu X, Yao X, Zhou Q, Hu H, Li M, Jiménez-Mesa C, Ramirez J, Martinez FJ, Gorriz JM. Advances in multimodal data fusion in neuroimaging: Overview, challenges, and novel orientation. AN INTERNATIONAL JOURNAL ON INFORMATION FUSION 2020; 64:149-187. [PMID: 32834795 PMCID: PMC7366126 DOI: 10.1016/j.inffus.2020.07.006] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/06/2020] [Accepted: 07/14/2020] [Indexed: 05/13/2023]
Abstract
Multimodal fusion in neuroimaging combines data from multiple imaging modalities to overcome the fundamental limitations of individual modalities. Neuroimaging fusion can achieve higher temporal and spatial resolution, enhance contrast, correct imaging distortions, and bridge physiological and cognitive information. In this study, we analyzed over 450 references from PubMed, Google Scholar, IEEE, ScienceDirect, Web of Science, and various sources published from 1978 to 2020. We provide a review that encompasses (1) an overview of current challenges in multimodal fusion (2) the current medical applications of fusion for specific neurological diseases, (3) strengths and limitations of available imaging modalities, (4) fundamental fusion rules, (5) fusion quality assessment methods, and (6) the applications of fusion for atlas-based segmentation and quantification. Overall, multimodal fusion shows significant benefits in clinical diagnosis and neuroscience research. Widespread education and further research amongst engineers, researchers and clinicians will benefit the field of multimodal neuroimaging.
Collapse
Affiliation(s)
- Yu-Dong Zhang
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
- Department of Information Systems, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Zhengchao Dong
- Department of Psychiatry, Columbia University, USA
- New York State Psychiatric Institute, New York, NY 10032, USA
| | - Shui-Hua Wang
- Department of Information Systems, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- School of Architecture Building and Civil engineering, Loughborough University, Loughborough, LE11 3TU, UK
- School of Mathematics and Actuarial Science, University of Leicester, LE1 7RH, UK
| | - Xiang Yu
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
| | - Xujing Yao
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
| | - Qinghua Zhou
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
| | - Hua Hu
- Department of Psychiatry, Columbia University, USA
- Department of Neurology, The Second Affiliated Hospital of Soochow University, China
| | - Min Li
- Department of Psychiatry, Columbia University, USA
- School of Internet of Things, Hohai University, Changzhou, China
| | - Carmen Jiménez-Mesa
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
| | - Javier Ramirez
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
| | - Francisco J Martinez
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
| | - Juan Manuel Gorriz
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
- Department of Psychiatry, University of Cambridge, Cambridge CB21TN, UK
| |
Collapse
|
4
|
Tumati S, Opmeer EM, Marsman JBC, Martens S, Reesink FE, De Deyn PP, Aleman A. Lower Choline and Myo-Inositol in Temporo-Parietal Cortex Is Associated With Apathy in Amnestic MCI. Front Aging Neurosci 2018; 10:106. [PMID: 29706886 PMCID: PMC5909116 DOI: 10.3389/fnagi.2018.00106] [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] [Received: 11/14/2017] [Accepted: 03/29/2018] [Indexed: 12/14/2022] Open
Abstract
Apathy is a common symptom in patients with amnestic mild cognitive impairment (aMCI) and is associated with an increased risk of progression to Alzheimer's disease (AD). The neural substrates underlying apathy in aMCI may involve multiple brain regions, including the anterior cingulate cortex and the temporo-parietal region. Here we investigated neurometabolites in brain regions that may underlie apathy in aMCI patients using proton magnetic resonance spectroscopy (1H-MRS). Twenty-eight aMCI patients with varying degrees of apathy and 20 matched controls underwent 1H-MRS. Spectra were acquired from single voxels in the posterior cingulate cortex (PCC), dorsal anterior cingulate cortex (DACC), right dorsolateral prefrontal cortex (DLPFC), and right temporo-parietal cortex (TPC). Apathy was measured with the Apathy Evaluation Scale (AES). Spearman partial correlations between metabolite concentrations in each region and severity of apathy were determined. Additionally, analyses of covariance (ANCOVA) were performed to determine whether metabolite changes differed between patients with or without clinically-diagnosed apathy. The degree of apathy was found to be negatively correlated with choline and myo-inositol (mI) in the TPC. Additional exploratory analyses suggested that N-acetylaspartate (NAA)/mI ratio was reduced in aMCI without clinical apathy but not in aMCI with clinical apathy. In the DACC, glutamate and glutamine (Glx) levels tended to be higher in the aMCI with apathy group compared to controls and reduced in association with depression scores. In conclusion, apathy in aMCI patients was associated with neurometabolite changes indicative of altered membranal integrity and glial function in the right TPC. Findings also indicated that in a clinically-diagnosed aMCI cohort, apathy symptoms may be suggestive of neural changes that are distinct from aMCI without apathy.
Collapse
Affiliation(s)
- Shankar Tumati
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.,Mind, Brain Imaging and Neuroethics Research Unit, Institute of Mental Health Research, University of Ottawa; Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Esther M Opmeer
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Jan-Bernard C Marsman
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Sander Martens
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Fransje E Reesink
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Peter P De Deyn
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.,Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - André Aleman
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.,Department of Psychology, University of Groningen, Groningen, Netherlands
| |
Collapse
|
5
|
Lang B, Kindy MS, Kozel FA, Schultz SK, Taheri S. Multi-Parametric Classification of Vascular Cognitive Impairment and Dementia: The Impact of Diverse Cerebrovascular Injury Biomarkers. J Alzheimers Dis 2018; 62:39-60. [DOI: 10.3233/jad-170733] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Brittany Lang
- Clinical Psychology Program, University of South Florida, Tampa, FL, USA
| | - Mark S. Kindy
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida Tampa, FL, USA
- James A. Haley VA Medical Center, Tampa, FL, USA
| | - F. Andrew Kozel
- James A. Haley VA Medical Center, Tampa, FL, USA
- Psychiatry and Behavioral Sciences, University of South Florida, Tampa, FL, USA
| | - Susan K. Schultz
- James A. Haley VA Medical Center, Tampa, FL, USA
- Psychiatry and Behavioral Sciences, University of South Florida, Tampa, FL, USA
| | - Saeid Taheri
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida Tampa, FL, USA
- Byrd Alzheimer’s Institute, Tampa, FL, USA
| |
Collapse
|
6
|
Zeydan B, Deelchand DK, Tosakulwong N, Lesnick TG, Kantarci OH, Machulda MM, Knopman DS, Lowe VJ, Jack CR, Petersen RC, Öz G, Kantarci K. Decreased Glutamate Levels in Patients with Amnestic Mild Cognitive Impairment: An sLASER Proton MR Spectroscopy and PiB-PET Study. J Neuroimaging 2017; 27:630-636. [PMID: 28661060 DOI: 10.1111/jon.12454] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/17/2017] [Accepted: 05/18/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND PURPOSE Glutamate levels may be informative about the declining neuronal health in the central nervous system. We used an advanced proton MR spectroscopy (1 H-MRS) protocol composed of semi-localization by adiabatic selective refocusing (sLASER) localization and FAST(EST)MAP shimming for detection of alterations in brain glutamate concentrations in patients with amnestic mild cognitive impairment. METHODS Participants with amnestic mild cognitive impairment (n = 14; median age = 80) and age- and sex-matched clinically normal controls (n = 32; median age = 79) from the population-based Mayo Clinic Study of Aging were recruited prospectively to the 3T single-voxel 1 H-MRS study that examined metabolite changes in the posterior cingulate gyri. To be included, controls had to have low β-amyloid load on [11 C] Pittsburgh Compound B (PiB)-PET (standard uptake value ratio; SUVr < 1.42) and patients with amnestic mild cognitive impairment had to have high β-amyloid load (SUVr ≥ 1.42). RESULTS Glutamate concentration and the glutamate/myo-inositol ratio were lower in patients with amnestic mild cognitive impairment than clinically normal controls (P < .05). Higher global cortical PiB-PET SUVr correlated with lower glutamate/myo-inositol (r = -.3, P = .04). CONCLUSIONS The advanced sLASER with FAST(EST)MAP shimming is a promising protocol for identifying glutamate alterations. Advanced 1 H-MRS protocols may add to the understanding of early Alzheimer's disease pathophysiology through detection of glutamate concentration in posterior cingulate gyri of individuals with amnestic mild cognitive impairment.
Collapse
Affiliation(s)
- Burcu Zeydan
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN.,Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN
| | - Dinesh K Deelchand
- Department of Radiology, University of Minnesota, Center for Magnetic Resonance Research, Minneapolis, MN
| | - Nirubol Tosakulwong
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN
| | - Timothy G Lesnick
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN
| | - Orhun H Kantarci
- Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN
| | - David S Knopman
- Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN
| | - Val J Lowe
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN
| | - Ronald C Petersen
- Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN
| | - Gülin Öz
- Department of Radiology, University of Minnesota, Center for Magnetic Resonance Research, Minneapolis, MN
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN
| |
Collapse
|
7
|
Scavuzzo CJ, Moulton CJ, Larsen RJ. The use of magnetic resonance spectroscopy for assessing the effect of diet on cognition. Nutr Neurosci 2016; 21:1-15. [DOI: 10.1080/1028415x.2016.1218191] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Claire J. Scavuzzo
- Neuroscience Program, University of Illinois at Urbana-Champaign, USA
- Department of Psychology, University of Alberta, Edmonton, Canada
| | | | - Ryan J. Larsen
- Biomedical Imaging Center, Beckman Institute, University of Illinois at Urbana-Champaign, USA
| |
Collapse
|
8
|
Chen SQ, Cai Q, Shen YY, Xu CX, Zhou H, Zhao Z. Hydrogen Proton Magnetic Resonance Spectroscopy in Multidomain Amnestic Mild Cognitive Impairment and Vascular Cognitive Impairment Without Dementia. Am J Alzheimers Dis Other Demen 2016; 31:422-9. [PMID: 26980718 PMCID: PMC10852783 DOI: 10.1177/1533317515628052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To investigate the value of hydrogen proton magnet resonance spectroscopy ((1)H-MRS) in the differential diagnosis of multiple-domain amnestic mild cognitive impairment (M-aMCI) and vascular cognitive impairment with no dementia (VCIND); (1)H-MRS was performed in patients with M-aMCI and VCIND. The level was determined for N-acetylaspartate (NAA), glutamate (Glu), inositol (mI), choline (Cho), and creatine (Cr). Compared with the normal control group, the NAA-Cr ratio in all regions studied was significantly lower in the M-aMCI and VCIND groups. The Glu-Cr ratio in the posterior cingulate gyrus of the M-aMCI group was significantly lower than in the VCIND. The mI-Cr ratio in the frontal white matter of the VCIND was significantly higher than in the M-aMCI group. In the white matter adjacent to the lateral ventricles, the Cho-Cr ratio was significantly higher in the VCIND than the M-aMCI. Our results suggested (1)H-MRS is an effective method in the differential diagnosis of M-aMCI and VCIND.
Collapse
Affiliation(s)
- Shuang-Qing Chen
- Department of Radiology, The Affiliated Suzhou Hospital, Nanjing Medical University, Suzhou, China
| | - Qing Cai
- Department of Radiology, The Affiliated Suzhou Hospital, Nanjing Medical University, Suzhou, China
| | - Yu-Ying Shen
- Department of Radiology, The Affiliated Suzhou Hospital, Nanjing Medical University, Suzhou, China
| | - Chuan-Xiao Xu
- Department of Radiology, The Affiliated Suzhou Hospital, Nanjing Medical University, Suzhou, China
| | - Hua Zhou
- Department of Neurology, The Affiliated Suzhou Hospital, Nanjing Medical University, Suzhou, China
| | - Zhong Zhao
- Department of Neurology, The Affiliated Suzhou Hospital, Nanjing Medical University, Suzhou, China
| |
Collapse
|
9
|
Bruce ED, Konda S, Dean DD, Wang EW, Huang JH, Little DM. Neuroimaging and traumatic brain injury: State of the field and voids in translational knowledge. Mol Cell Neurosci 2015; 66:103-13. [DOI: 10.1016/j.mcn.2015.03.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 03/24/2015] [Accepted: 03/25/2015] [Indexed: 01/07/2023] Open
|
10
|
Yin C, Li S, Zhao W, Feng J. Brain imaging of mild cognitive impairment and Alzheimer's disease. Neural Regen Res 2014; 8:435-44. [PMID: 25206685 PMCID: PMC4146132 DOI: 10.3969/j.issn.1673-5374.2013.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 12/03/2012] [Indexed: 11/18/2022] Open
Abstract
The rapidly increasing prevalence of cognitive impairment and Alzheimer's disease has the potential to create a major worldwide healthcare crisis. Structural MRI studies in patients with Alzheimer's disease and mild cognitive impairment are currently attracting considerable interest. It is extremely important to study early structural and metabolic changes, such as those in the hippocampus, entorhinal cortex, and gray matter structures in the medial temporal lobe, to allow the early detection of mild cognitive impairment and Alzheimer's disease. The microstructural integrity of white matter can be studied with diffusion tensor imaging. Increased mean diffusivity and decreased fractional anisotropy are found in subjects with white matter damage. Functional imaging studies with positron emission tomography tracer compounds enable detection of amyloid plaques in the living brain in patients with Alzheimer's disease. In this review, we will focus on key findings from brain imaging studies in mild cognitive impairment and Alzheimer's disease, including structural brain changes studied with MRI and white matter changes seen with diffusion tensor imaging, and other specific imaging methodologies will also be discussed.
Collapse
Affiliation(s)
- Changhao Yin
- Department of Neurology, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China ; Department of Neurology, Hongqi Hospital, Mudanjiang Medical University, Mudanjiang 157004, Heilongjiang Province, China
| | - Siou Li
- Department of Neurology, Hongqi Hospital, Mudanjiang Medical University, Mudanjiang 157004, Heilongjiang Province, China
| | - Weina Zhao
- Department of Neurology, Hongqi Hospital, Mudanjiang Medical University, Mudanjiang 157004, Heilongjiang Province, China
| | - Jiachun Feng
- Department of Neurology, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| |
Collapse
|
11
|
Magnetic resonance spectroscopy in the diagnosis of dementia with Lewy bodies. BIOMED RESEARCH INTERNATIONAL 2014; 2014:809503. [PMID: 25110697 PMCID: PMC4109391 DOI: 10.1155/2014/809503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 05/21/2014] [Accepted: 06/20/2014] [Indexed: 01/03/2023]
Abstract
Dementia with Lewy bodies (DLB) is considered to be the second most frequent primary degenerative dementing illness after Alzheimer's disease (AD). DLB, together with Parkinson's disease (PD), Parkinson's disease with dementia (PDD) belong to α-synucleinopathies—a group of neurodegenerative diseases associated with pathological accumulation of the α-synuclein protein. Dementia due to PD and DLB shares clinical symptoms and neuropsychological profiles. Moreover, the core features and additional clinical signs and symptoms for these two very similar diseases are largely the same. Neuroimaging seems to be a promising method in differential diagnosis of dementia studies. The development of imaging methods or other objective measures to supplement clinical criteria for DLB is needed and a method which would accurately facilitate diagnosis of DLB prior to death is still being searched. Proton magnetic resonance spectroscopy (1H-MRS) provides a noninvasive method of assessing an in vivo biochemistry of brain tissue. This review summarizes the main results obtained from the application of neuroimaging techniques in DLB cases focusing on 1H-MRS.
Collapse
|
12
|
Gao F, Barker PB. Various MRS application tools for Alzheimer disease and mild cognitive impairment. AJNR Am J Neuroradiol 2014; 35:S4-11. [PMID: 24742809 DOI: 10.3174/ajnr.a3944] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
MR spectroscopy is a noninvasive technique that allows the detection of several naturally occurring compounds (metabolites) from well-defined regions of interest within the human brain. Alzheimer disease, a progressive neurodegenerative disorder, is the most common cause of dementia in the elderly. During the past 20 years, multiple studies have been performed on MR spectroscopy in patients with both mild cognitive impairment and Alzheimer disease. Generally, MR spectroscopy studies have found decreased N-acetylaspartate and increased myo-inositol in both patients with mild cognitive impairment and Alzheimer disease, with greater changes in Alzheimer disease than in mild cognitive impairment. This review summarizes the information content of proton brain MR spectroscopy and its related technical aspects, as well as applications of MR spectroscopy to mild cognitive impairment and Alzheimer disease. While MR spectroscopy may have some value in the differential diagnosis of dementias and assessing prognosis, more likely its role in the near future will be predominantly as a tool for monitoring disease response or progression in treatment trials. More work is needed to evaluate the role of MR spectroscopy as a biomarker in Alzheimer disease and its relationship to other imaging modalities.
Collapse
Affiliation(s)
- F Gao
- From the Shandong Medical Imaging Research Institute (F.G.), Shandong University, Jinan, China
| | - P B Barker
- Russell H. Morgan Department of Radiology and Radiological Science (P.B.B.), Johns Hopkins University School of Medicine, Baltimore, MarylandF.M. Kirby Research Center for Functional Brain Imaging (P.B.B.), Kennedy Krieger Institute, Baltimore, Maryland.
| |
Collapse
|
13
|
Magnetic resonance spectroscopy in mild cognitive impairment: systematic review and meta-analysis. Neurosci Biobehav Rev 2013; 37:2571-86. [PMID: 23969177 DOI: 10.1016/j.neubiorev.2013.08.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 07/17/2013] [Accepted: 08/11/2013] [Indexed: 01/28/2023]
Abstract
Research using proton magnetic resonance spectroscopy (MRS) can potentially elucidate metabolite changes representing early degeneration in Mild Cognitive Impairment (MCI), an early stage of dementia. We integrated the published literature using meta-analysis to identify patterns of metabolite changes in MCI. 29 MRS studies (with a total of 607 MCI patients and 862 healthy controls) were classified according to brain regions. Hedges' g was used as effect size in a random effects model. N-Acetyl Aspartate (NAA) measures were consistently reduced in posterior cingulate (PC), hippocampus, and the paratrigonal white matter (PWM). Creatine (Cr) concentration was reduced in the hippocampus and PWM. Choline (Cho) concentration was reduced in the hippocampus while Cho/Cr ratio was raised in the PC. Myo-inositol (mI) concentration was raised in the PC and mI/Cr ratio was raised in the hippocampus. NAA/mI ratio was reduced in the PC. NAA may be the most reliable marker of brain dysfunction in MCI though mI, Cho, and Cr may also contribute towards this.
Collapse
|
14
|
Wang S, Yuan J, Guo X, Peng P, Gu H, Niu S, Fregni F, Chen ACN, Hu W. Neurochemical correlates of cognitive dysfunction in patients with leukoaraiosis: a proton magnetic resonance spectroscopy study. Neurol Res 2012; 34:989-97. [PMID: 23146302 DOI: 10.1179/1743132812y.0000000104] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES Leukoaraiosis (LA) is a common radiological finding in the elderly and may reflect cerebral small vessel disease (SVD). Although SVD has been identified as a major cause of vascular cognitive impairment or vascular dementia, the mechanisms for this association remain unclear. We therefore aimed to measure brain metabolites in LA using proton magnetic resonance spectroscopy ((1)H-MRS) as to determine the relationship between cognitive function and neurochemical white matter profile. METHODS We recruited 23 patients with LA and 23 age- and sex-matched healthy controls consecutively. Multi-voxel (1)H-MRS was performed with a volume of interest located in centrum semiovale that contained mainly white matter voxels. Three main ratios of N-acetyl aspartate (NAA)/Cr, choline (Cho)/Cr and NAA/Cho were obtained. Spearman rank correlation coefficients were calculated between the cognitive function and the measured metabolite ratios. RESULTS We found significantly lower levels of NAA/Cho and NAA/Cr ratios in lesioned white matter in patients with LA than healthy controls (P<0.05). The ratios of NAA/Cho and NAA/Cr in normal appearing white matter (NAWM) were higher than lesioned white matter and lower than controls, but this difference was not significant (P>0.05). There was a positive relationship between Mini-Mental State Examination (MMSE) and NAA/Cho in NAWM (r = 0.417, P = 0.048), and also a positive relationship between MMSE and NAA/Cr in lesioned white matter (r = 0.551, P = 0.006) in patients with LA. A positive relationship between the Z scores of the executive function and NAA/Cho in lesioned white matter (r = 0.557, P = 0.006) was also found. CONCLUSION The main finding of this study was a significant reduction in the ratios of NAA/Cr and NAA/Cho in lesioned white matter, which indicates a marker of neuronal loss or dysfunction in patients with LA, which was correlated with cognitive function. This relationship between cognitive function and metabolic changes suggests that (1)H-MRS can be explored as a marker for cognitive dysfunction in patients with LA.
Collapse
Affiliation(s)
- Shuangkun Wang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Lim TS, Hong YH, Lee HY, Choi JY, Kim HS, Moon SY. Metabolite investigation in both anterior and posterior cingulate gyri in Alzheimer's disease spectrum using 3-tesla MR spectroscopy. Dement Geriatr Cogn Disord 2012; 33:149-55. [PMID: 22722669 DOI: 10.1159/000338177] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/05/2012] [Indexed: 11/19/2022] Open
Abstract
AIMS In order to evaluate the metabolite changes of both anterior and posterior cingulate gyri during the progression of Alzheimer's disease (AD) pathology, a 3-tesla MR spectroscopy study was performed. METHODS Thirty-six patients with AD, 19 patients with amnestic mild cognitive impairment (aMCI), and 23 cognitively normal (CN) subjects were recruited. MR spectroscopy was conducted within the anterior and posterior cingulate gyri. A one-way analysis of co-variance was used to compare the metabolite ratios of each group and correlation analysis was used to show the correlation between the metabolite ratios with the Mini-Mental State Examination (MMSE) and Neuropsychiatric Inventory (NPI). RESULTS The N-acetylaspartate/creatine (NAA/Cr) of the posterior cingulate gyrus was significantly higher in CN subjects than in aMCI and AD patients. On the other hand, the myoinositol/creatine (ml/Cr) of the anterior cingulate gyrus was significantly higher in AD patients than in CN subjects and aMCI patients. The ml/Cr of the posterior cingulate gyrus correlated with the MMSE and that of the anterior cingulate gyrus correlated with the NPI. CONCLUSION Both the decreased NAA/Cr of the posterior cingulate gyrus and the increased ml/Cr of the anterior cingulate gyrus may reflect biochemical changes in AD according to the posterior-dominant progression of AD pathology.
Collapse
Affiliation(s)
- Tae Sung Lim
- Department of Neurology, Ajou University School of Medicine, Suwon, Republic of Korea
| | | | | | | | | | | |
Collapse
|
16
|
Current strategies in the discovery of small-molecule biomarkers for Alzheimer’s disease. Bioanalysis 2011; 3:1121-42. [DOI: 10.4155/bio.11.62] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
With the number of patients suffering from Alzheimer’s disease rapidly increasing, there is a major requirement for an accurate biomarker capable of diagnosing the disease early. Much of the research is focused on protein and genetic approaches; however, small molecules may provide viable marker molecules. Examples that support this approach include known abnormalities in lipid metabolism, glucose utilization and oxidative stress, which have been demonstrated in patients suffering from the disease. Therefore, by-products of this irregular metabolism may provide accurate biomarkers. In this review we present the current approaches previously published in the literature used to investigate potential small-molecule and metabolite markers, and report their findings. A wide range of techniques are discussed, including separation approaches (LC, GC and CE), magnetic resonance technologies (NMR and magnetic resonance spectroscopy), and immunoassays.
Collapse
|
17
|
[Mild cognitive impairment: diagnostic value of different MR techniques]. Radiologe 2011; 51:285-92. [PMID: 21448679 DOI: 10.1007/s00117-010-2094-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In view of an increasingly aging population the prevalence of dementia is also expected to increase rapidly. As well as clinical, neuropsychological and laboratory procedures magnetic resonance imaging (MRI) plays an important role in the early diagnosis of dementia which is important in the precursor stage of mild cognitive impairment (MCI). On the one hand this stage is associated with an increased risk of dementia and on the other hand an early treatment in this stage could attenuate development of the disease. In addition to morphological changes different functional MRI techniques can help in the early diagnosis of dementia and the precursor stages. Moreover, it is important to detect those MCI patients who are at particularly risk for developing dementia. In the differentiation of converters to non-converters initial studies suggest that particularly voxel-based morphometry, MR spectroscopy and diffusion tensor imaging can provide important additional information.
Collapse
|
18
|
Magnetic resonance spectroscopic methods for the assessment of metabolic functions in the diseased brain. Curr Top Behav Neurosci 2011; 11:169-98. [PMID: 22076698 DOI: 10.1007/7854_2011_166] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Magnetic resonance spectroscopy (MRS) is a non-invasive technique that can be used to detect and quantify multiple metabolites. This chapter will review some of the applications of MRS to the study of brain functions. Typically, (1)H-MRS can detect metabolites reflecting neuronal density and integrity, markers of energy metabolism or inflammation, as well as neurotransmitters. The complexity of the proton spectrum has however led to the development of other nuclei-based methods, such as (31)P- and (13)C-MRS, which offer a broader chemical shift range and therefore can provide more detailed information at the level of single metabolites. The versatility of MRS allows for a wide range of clinical applications, of which neurodegeneration is an interesting target for spectroscopy-based studies. In particular, MRS can identify patterns of altered brain chemistry in Alzheimer's patients and can help establish differential diagnosis in Alzheimer's and Parkinson's diseases. Using MRS to follow less abundant neurotransmitters is currently out of reach and will most likely depend on the development of methods such as hyperpolarization that can increase the sensitivity of detection. In particular, dynamic nuclear polarization has opened up a new and exciting area of medical research, with developments that could greatly impact on the real-time monitoring of in vivo metabolic processes in the brain.
Collapse
|
19
|
Efecto regional, de la edad y el sexo en la espectroscopia por resonancia magnética cerebral. RADIOLOGIA 2010; 52:342-50. [DOI: 10.1016/j.rx.2010.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2009] [Revised: 04/19/2010] [Accepted: 04/21/2010] [Indexed: 11/22/2022]
|
20
|
Abstract
With an increasingly aging population we are faced with the problem of an increasing number of dementia patients. In addition to clinical, neuropsychological and laboratory procedures, MRI plays an important role in the early diagnosis of dementia. In addition to various morphological changes functional changes can also help in the diagnosis and differential diagnosis of dementia. Overall the diagnosis of dementia can be improved by using parameters from MR spectroscopy. This article focuses on MR spectroscopic changes in the physiological aging process as well as on changes in mild cognitive impairment a precursor of Alzheimer's dementia, in Alzheimer's dementia, frontotemporal dementia, vascular dementia and Lewy body dementia.
Collapse
Affiliation(s)
- T Hauser
- Abteilung E010, Radiologie, Deutsches Krebsforschungszentrum (DKFZ) Heidelberg , Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland.
| | | | | | | | | |
Collapse
|
21
|
García Santos J, Fuentes L, Vidal J, Antequera M, Torres Del Río S, Antúnez C, Ortega G. Regional effects of age and sex in magnetic resonance spectroscopy. RADIOLOGIA 2010. [DOI: 10.1016/s2173-5107(10)70023-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
22
|
Cerebral metabolic changes in neurologically presymptomatic patients undergoing haemodialysis: in vivo proton MR spectroscopic findings. Eur Radiol 2009; 20:1502-7. [PMID: 19997847 DOI: 10.1007/s00330-009-1673-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Revised: 09/09/2009] [Accepted: 10/10/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To prospectively investigate and detect early cerebral metabolic changes in patients with end-stage renal disease (ESRD) by using in vivo proton MR spectroscopy (MRS). METHODS We enrolled 32 patients with ESRD and 32 healthy controls between the ages of 26 and 50 years. Short echo time single-voxel proton MRS was acquired from volumes of interest (VOIs) located in the frontal grey and white matter, temporal white matter and basal ganglia. The choline/phospatidylcholine (Cho), myo-inositol (mI), N-acetylaspartate (NAA) and total creatine (tCr) peaks were measured and the metabolic ratios with respect to tCr were calculated. RESULTS In the ESRD group, significant elevations of the Cho/tCr and mI/tCr ratios were observed for the frontal grey matter, frontal white matter, temporal white matter and basal ganglia as compared with controls. There was no significant difference in the NAA/tCr ratios at all VOIs between the ESRD patients and the healthy controls. CONCLUSIONS Proton MRS is a useful and non-invasive imaging tool for the detection of early cerebral metabolic changes in neurologically presymptomatic ESRD patients.
Collapse
|
23
|
Griffith HR, Stewart CC, den Hollander JA. Proton magnetic resonance spectroscopy in dementias and mild cognitive impairment. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2009; 84:105-31. [PMID: 19501715 DOI: 10.1016/s0074-7742(09)00406-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
With the anticipated increase in dementias due to the aging demographic of industrialized nations, biomarkers for neurodegenerative diseases are increasingly important as new therapies are being developed for clinical trials. Proton MR spectroscopy ((1)H MRS) appears poised to be a viable means of tracking brain metabolic changes due to neurodegenerative diseases and potentially as a biomarker for treatment effects in clinical therapeutic trials. This review highlights the body of literature investigating brain metabolic abnormalities in Alzheimer's disease, amnestic mild cognitive impairment, frontotemporal dementia, vascular dementia, Lewy body dementia, and Parkinson's disease dementia. In particular, the review addresses the viability of (1)H MRS to discriminate among dementias, to measure disease progression, and to measure the effects of pharmacological treatments. While findings to date are encouraging, more study is needed in longitudinal patterns of brain metabolic changes, correspondence with changes in clinical markers of disease progression, and sensitivity of (1)H MRS measures to treatment effects. Such developments will hopefully benefit the search for effective treatments of dementias in the twenty-first century.
Collapse
Affiliation(s)
- H Randall Griffith
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama 35233, USA
| | | | | |
Collapse
|