Mild Cognitive Impairment And Alzheimer's Disease In Hippocampus MR Spectroscopy

Objective To evaluate the neuropsychological assessment of Alzheimer's disease(AD),mild cognitive impairment(MCI)and normal control(NC)groups respectively and to detect the changes of metabolite concentration by 3.0T 1-H proton magnetic resonance spectroscopy in hippocampus and calculate the ratio,and the combination of both to explore the hippocampal spectrum of diagnostic value in AD and MCI.Methods AD,MCI and NC groups were recruited from Affiliated Zhongshan Hospital Dalian University.All Subjects are evaluated by a trained neuropsychological evaluator for assessment of cognitive and life skills,with bilateral hippocampus 3.0T1 H MRS scanning,the concentrations of NAA,Cho and Cr were determined,and the ratios of metabolites to Cr and Cho / NAA were calculated.Finally,statistical software was used to analyze the differences among the three groups Hippocampus metabolites ratio and to detect the correlations the different ratios of each metabolite and neuropsychological score.Results1.Comparison of neuropsychological scores among AD,MCI and NC groups(Table3): The scores of MMSE and Mo CA in the former two groups were lower than those in NC group,and the scores of ADL were higher than those in NC group(P<0.05);the total scole of MMSE and Mo CA in MCI group were higher than those in AD group,while the total scole of ADL in AD group was higher than that in MCI group(P <0.05);The total score of MMSE and Mo CA in AD,MCI and healthy control groups gradually increased,and the total score of ADL decreased in turn,the difference was significant(P <0.05).2.The comparison of metabolite concentration ratio in hippocampus in AD?MCI and NC groups(Table 4):2.1 The ratios of metabolites in the left hippocampus were compared in AD?MCI and NC groups: the ratios of NAA / Cr,Cho / Cr and Cho / NAA in the three groups were significantly different(P <0.05);The ratios of NAA / Cr in AD group were lower than those in MCI group(P <0.05);The ratios of Cho / Cr and Cho / NAA in AD group were higher than those in MCI group(P <0.05).The ratios of NAA / Cr and Cho / Cr in NC group were higher than those in AD group,The ratios of Cho/NAA in AD group were higher than those in NC group(P <0.05);However,the ratios of Cho / Cr and Cho / NAA in NC group were higher than those in MCI group(P <0.05).There was no significant difference in NAA / Cr ratio between MCI group and NC group(P> 0.05).2.2 The ratios of metabolites in the right hippocampus were compared in AD?MCI and NC groups: The ratios of NAA / Cr and Cho / Cr in AD,MCI and NC groups were significantly different(P <0.05),The ratios of Cho/NAA in the three groups were not significantly different(P> 0.05);the ratios of NAA / Cr and Cho / Cr in MCI group were higher than those in AD group(P<0.05);the ratios of NAA / Cr and Cho / Cr in NC group were higher than those in AD group(P<0.05);However,There was no significant difference in the ratios of NAA/Cr and Cho/Cr between MCI group and NC group(P> 0.05).3.The correlation between metabolite ratio and neuropsychological score in AD group and MCI group(Table 5,6):The ratios of NAA / Cr in left hippocampus in AD and MCI groups,The ratios of NAA / Cr in right hippocampus in AD were positively correlated with MMSE and Mo CA scores(P <0.05).The left hippocampus Cho / Cr ratio in AD group was positively correlated with MMSE score(P <0.05).NAA / Cr,Cho / Cr ratio in bilateral AD and left NAA / Cr ratio in MCI group were all negatively correlated with ADL score(P <0.05).Other Metabolites ratio and psychology scores are no significant correlation(P> 0.05).Conclusion1.3.0T multi-voxel 1H MRS technology can relatively accurately detect the AD and MCI patients bilateral hippocampal metabolites concentration changes,which can be more accurate understanding of AD and MCI patients with pathophysiology and biochemical metabolic progression.2.The ratios of NAA / Cr,Cho / Cr and Cho / NAA in hippocampus may be an objective basis for the early metabolites of MCI and AD,which may serve as an indicator of early diagnosis of MCI and AD,and dynamically monitor the progress of the disease and guide the clinical treatment.