Doença de Alzheimer e espectroscopia por ressonância magnética do hipocampo

Engelhardt, Eliasz; Moreira, Denise Madeira; Laks, Jérson; Marinho, Valeska; Rozenthal, Márcia; Oliveira, Amarino Carvalho de

doi:10.1590/s0004-282x2001000600006

Cited by 22 publications

(15 citation statements)

References 19 publications

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“…The progressive decrease of Naa also runs in parallel with the decline of the MMSE scores (compare Table 1 and Table 2) obtained in each clinical stage. Such observation has been reported in only a few AD studies 9,[20][21][22] .…”

Section: Discussionmentioning

confidence: 80%

“…Several studies on the hippocampus 9,11,14,[16][17][18]20 and one on the cingulum 19 with mild or mild-moderate AD patients were found in the literature. H o w e v e r, no studies were found in which spectroscopic data of these limbic regions are compared and related to the clinical severity stages of AD and normal controls.…”

Section: Discussionmentioning

confidence: 99%

“…This corresponds to the primary neurometabolite change in AD brain, reflecting neuronal dysfunction/loss. Changes of other metabolites are probably corollary occurrences [7][8][9][10][11][12][13] . Several studies have addressed this question aiming the hippocampal region 9 , 1 1 , 1 4 -1 8 in mild-moderate AD patients.…”

Section: Resumo -O B J E T I V Omentioning

confidence: 99%

“…Correlations of neurometabolites with cognitive assessment (ex., MiniMental State Examination/MMSE, Alzheimer's Disease Assessment Scale-cognitive section (ADAScog) were found in only a few AD studies 7 . Studies correlating Naa and cognition were mostly performed aiming the medial temporal region on mild 2 0 , 2 1 and mild-moderate AD patients 9,22 . Other cortical regions thought to be important in memory circuits, like the posterior cingulum, were less studied 1 9 .…”

Section: Resumo -O B J E T I V Omentioning

confidence: 99%

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Alzheimer's disease and proton magnetic resonance spectroscopy of limbic regions: a suggestion of a clinical-spectroscopic staging

Engelhardt

Moreira

Laks

et al. 2005

Arq. Neuro-Psiquiatr.

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Alzheimer's disease (AD) is the most common degenerative dementia. It progressively aff e c t s cortical areas and subcortical structures, undermining the normal function, and leads to progressive cognitive and functional decline and to the appearance of behavioral disorders. Considering the severity and the prevalence of this disease there is a growing interest focused on its underlying processes and the possibility of early diagnosis. The brains of AD patients exhibit neuropathologic changes (senile plaques, neurofibrillary tangles, neuronal loss, glial reaction). Considering the neurofibrillary degeneration, the degenerative process observed in AD presents a sequential pattern as determined by Braak and Braak's 1 n e u r o f i b r i l l a r y tangle/NFT and Delacourte's and al.2 paired helical (12) and with AD (34), paired to age (CDR0-CDR3); AD diagnosis according to DSM-IV/NINCDS-ADRDA criteria; 1 H-MRS with Signa Horizon LX-GE, 1.5T; single voxel at hippocampal region/HCR and posterior cingulate area/PCA. Results: Statistically significant decrease (p<0.01) only of Naa/Cr -at HCR among the CDR0, CDR1+CDR2, and CDR3, and at PCA between CDR0 and CDR1+CDR2 in relation to CDR3. Conclusion: The HCR is the first to show Naa reduction (CDR1). The PCA suffers later (CDR3). These values decline progressively according to the severity stages. Considering the disparities between the HCR and PCA it is possible to suggest a spectroscopic (metabolite) staging (MS) of AD, as follows: MS0 (~CDR0)=both normal HCR and PCA, MS1-2 (~CDR1-2)=abnormal HCR and normal PCA, and MS3 (~CDR3)=both abnormal HCR and PCA. These results make possible the early diagnosis, to follow the degenerative process throughout the course, and to suggest a spectroscopic staging related to the clinical stages of AD. ALZHEIMER'S DISEASE AND PROTON MAGNETIC RESONANCE SPECTROSCOPY OF LIMBIC REGIONSKEY WORDS: Alzheimer disease, 1 H-MRS, Naa, disease staging. Doença de Alzheimer e espectroscopia de prótons por ressonância magnética de regiões límbicas: sugestão de um estadiamento clínico-espectroscópico RESUMO -O b j e t i v o :Comparar dados de espectroscopia de prótons por ressonância magnética com clínicos e propor um estadiamento espectroscópico da doença de Alzheimer (DA). Método: Sujeitos (n=46), normais (12) e com DA (34), emparelhados por idade (CDR0-CDR3); diagnóstico de DA de acordo com os critérios DSM-IV/NINCDS-ADRDA; 1 H-MRS com Signa Horizon LX-GE, 1.5T; voxel único em região hipocampal/RHC e área posterior do cíngulo/APC. Resultados: Redução estatisticamente significativa (p<0.01) apenas de Naa/Cr -na RHC entre CDR0, CDR1+CDR2 e CDR3, e na APC entre CDR0 e CDR1+CDR2 em relação a CDR3. Conclusão: A RHC é a primeira a apresentar redução de Naa (CDR1). A APC é acometida mais tardiamente (CDR3). Esses valores declinam progressivamente de acordo com os estágios de gravidade. Considerando as disparidades entre a RHC e a APC é possível sugerir um estadiamento espectroscópico (metabólico) (MS) da DA como segue: MS0 (~CDR0)=RHC e APC ambos normais,...

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Resumo -O B J E T I V Omentioning

confidence: 99%

Section: Resumo -O B J E T I V Omentioning

confidence: 99%

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Alzheimer's disease and proton magnetic resonance spectroscopy of limbic regions: a suggestion of a clinical-spectroscopic staging

Engelhardt

Moreira

Laks

et al. 2005

Arq. Neuro-Psiquiatr.

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“…O mio-inositol também foi maior no grupo de indivíduos controles quando comparados com DA e CIND, achado esse em desacordo com a literatura. Engelhardt et al 38 encontraram v a l o res do NAA reduzidos, do mI aumentados e da relação mI/NAA aumentados em pacientes com DA. A sensibilidade, a especificidade e o valor preditivo positivo para esses dados foram satisfatórios para diagnosticar DA.…”

Section: Discussionunclassified

Espectroscopia de prótons na doença de Alzheimer e no comprometimento cognitivo sem demência: estudo de uma amostra comunitária

Azevedo

Bottino

Tatsch

et al. 2005

Arq. Neuro-Psiquiatr.

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RESUMO -Objetivo: D e s c rever os achados da espectroscopia de prótons ( 1 H-ERM) na doença de Alzheimer (DA) e no comprometimento cognitivo sem demência (CIND) em uma amostra da comunidade. M é t o d o :Foram avaliados seis pacientes com DA, sete com CIND e sete controles normais, originários da comunidade. 1 H-ERM foi realizada com voxel de 8 cm 3 nas regiões temporal direita, parietal esquerda e occipital medial e estudados os metabólitos: N-acetilaspartato (NAA), creatina (Cr), colina (Cho) e mio-inositol (mI). R e s u ltados: O NAA foi maior nos indivíduos controles do que nos DA e intermediário no CIND. Análise de função discriminante mostrou que as associações Cr parietal-Cr occipital e Cr parietal-Cho occipital identificaram c o rretamente 92,3% da amostra comparando Controle vs DA. Na comparação Controle vs CIND O mI temporal identificou corretamente 78,6% dos indivíduos. Conclusão: A espectroscopia pode contribuir para o diagnóstico e seguimento de indivíduos com comprometimento cognitivo; avaliações de pacientes da comunidade podem revelar achados diferentes quanto à distribuição dos metabólitos cerebrais.PA L AV R A S -C H AVE: ressonância magnética, espectroscopia prótons, doença de Alzheimer, compro m e t i m e n t o cognitivo.P roton spectroscopy in Alzheimer´s disease and cognitive impairment not dementia: a community study ABSTRACT -Objective: To describe the proton magnetic resonance spectroscopy ( 1 H-ERM) data in Alzheimer´s disease (AD) and Cognitive Impairment Not Dementia (CIND) in a community sample. Method: We investigated subjects with AD (n=6), CIND (n=7) and normal control (n=7). ) placed in temporal, parietal e occipital regions and studied metabolites were: N-acetylaspart a t e (NAA), creatine (Cr), choline (Cho) and myo-inositol (mI). Results: NAA concentration was higher in contro l subjects than AD and intermediated in CIND patients. Cho parietal plus occipital and Cr parietal plus Cho occipital classified correctly 92.3% of subjects Control vs AD. Temporal mI classified 78.6% of subjects between Control vs CIND. Conclusion: S p e c t roscopy can be used in the diagnosis and follow-up of individuals with cognitive impairment; evaluation of community subjects may show diff e rent patterns of brain metabolites distribution.KEY WORDS: magnetic resonance, proton spectroscopy, Alzheimer's disease, cognitive impairment. . Questiona -se a existência de um continuum entre idosos normais e aqueles com essa cond ição clínica, sobretudo se pessoas com queixas cognitivas irão evoluir para um quadro instalado de D A . Os critérios de inclusão e exclusão para caracterizar essas condições s ã o muito específicos e acabam por se tornar restritivos. Um conceito mais abrangente e menos re s t r itivo denominado comprometimento cognitivo sem demência (CIND em inglês) tem sido utilizado 6,7 .

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Canavan disease: A white matter disorder

Kumar

Mattan

Vellis

2006

Ment. Retard. Dev. Disabil. Res. Rev.

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Breakdown of oligodendrocyte-neuron interactions in white matter (WM), such as the loss of myelin, results in axonal dysfunction and hence a disruption of information processing between brain regions. The major feature of leukodystrophies is the lack of proper myelin formation during early development or the onset of myelin loss late in life. These early childhood WM diseases are described as hypomyelination or dysmyelination arising from a primary block in normal myelin synthesis because of a genetic mutation expressed in oligodendrocytes, or failure in myelination secondary to neuronal or astroglial dysfunctions (van der Knaap 2001 Dev. Med. Child Neurol. 43:705-712). Here, we describe the pathophysiological parameters of Canavan disease (CD), caused by genetic mutations of the aspartoacylase (ASPA) gene, a metabolic enzyme restricted in the central nervous system (CNS) to oligodendrocytes. CD presents pathophysiological dysfunctions similar to diseases caused by myelin gene mutations, such as Pelizaeus-Merzbacher disease (PMD) and several animal models, such as myelin deficient rat (md), jimpy (jp), shiverer (sh), and quaking (qk viable) mutant mice. These single gene mutations have pleiotropic effects, whereby the alteration of one myelin gene expression disrupts functional expression of other oligodendrocyte genes with an outcome of hypomyelination/dysmyelination. Among all of the known leukodystrophies, CD is the first disorder, which was approved and tested for the adeno-associated virus vector (AAV)-ASPA gene therapy (Leone et al. 2000 Ann. Neurol. 48:27-38; Janson et al. 2001 Trends Neurosci. 24:706-712) without much success following the first two attempts. ASPA gene delivery attempts in animal models have shown a lowering of N-acetyl L-aspartate and a change in motor functions, while sponginess of the WM, a characteristic of CD remained unchanged (Matalon et al. 2003 Mol. Ther. 7 (5, Part 1):580-587; McPhee et al. 2005 Brain Res. Mol. Brain Res. 135:112-121) even with better viral serotype and delivery of the gene during early phase of development (Klugmann et al. 2005 Mol. Ther. 11:745-753). While different approaches are being sought for the success of gene therapy, there are pivotal developmental questions to address regarding the specific regions of the CNS and cell lineages that become the target for the onset and progression of CD symptoms from early to late stages of development.

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Doença de Alzheimer e espectroscopia por ressonância magnética do hipocampo

Cited by 22 publications

References 19 publications

Alzheimer's disease and proton magnetic resonance spectroscopy of limbic regions: a suggestion of a clinical-spectroscopic staging

Alzheimer's disease and proton magnetic resonance spectroscopy of limbic regions: a suggestion of a clinical-spectroscopic staging

Espectroscopia de prótons na doença de Alzheimer e no comprometimento cognitivo sem demência: estudo de uma amostra comunitária

Canavan disease: A white matter disorder

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