A Comprehensive Review of Proton Magnetic Resonance Spectroscopy Studies in Dementia and Parkinson’s Disease

Abstract

We reviewed the literature of proton magnetic resonance spectroscopy (MRS) in dementia and Parkinson’s disease (PD) and quantitatively compared the reported values of the markers N-acetyl aspartate (NAA), choline, and myo-Inositol between control and disease groups. We analysed a total of 27 reports in dementia. Combining the quantitative data from these showed a relative decrease of 15% in NAA level in the temporal lobe tissue in patients with Alzheimer’s disease (AD) compared with controls. The rest of the brain showed a seemingly uniform 10% decrease in NAA levels in AD compared with controls. myo-Inositol was raised by about 15%, again uniformly throughout the brain, but there was no evidence for changed levels of choline. We found 15 reports of MRS in PD, which show a small decrease (5%) in the NAA level in the lentiform nucleus compared with controls. In progressive supranuclear palsy (PSP), there is a greater decrease in NAA levels in the frontal region and the lentiform nucleus. This may aid in the diagnosis of PSP. Further research is needed to determine spectroscopic changes in other dementias, to monitor how markers change with disease progression and to establish clinical utility.

Quantitative1H Magnetic Resonance Spectroscopic Imaging Determines Therapeutic Immunization Efficacy in an Animal Model of Parkinson's Disease

“…Its use as a diagnostic test for PD has been hampered by the inability of previous tests to precisely localize it to the SNpc, a necessary prerequisite because of the exacting relationship of NAA to neuronal injury and the requirement for high-field MRSI to ensure precise quantitative measurements (Clarke et al, 1997;Cruz et al, 1997;Federico et al, 1997;Brooks, 2000;Clarke and Lowry, 2000;Firbank et al, 2002;Baik et al, 2003). Nevertheless, a number of advantages to NAA measurements are evident, including its exclusive relationship to synthesis in neuronal mitochondria and reduction in mitochondrial dysfunction (Clark, 1998;Signoretti et al, 2001).…”

Ways toward an early diagnosis in Alzheimer's disease: The Alzheimer's Disease Neuroimaging Initiative (ADNI)

“…The degree of cognitive impairment was found to be well correlated with the degree of NAA decrease [90]. In addition, several studies found MRS also useful in differentiating AD from other forms of dementia, eg, vascular dementia, fronto-temporal lobe dementia [85,86,[91][92][93].…”

Neuroimaging in Parkinson's Disease

“…Proton magnetic resonance spectroscopy of the striatum has provided variable results in PD itself, but this technique may be useful for differentiating between PD and atypical parkinsonian syndromes, such as multiple system atrophy or progressive supranuclear palsy [13][14][15][16], and there may also be changes in the posterior cingulate [17] and presupplementary motor area cortex [18]. Phosphorus spectroscopy may also reveal changes that appear to differ between PD and multiple system atrophy [19,20].…”