Magnetic resonance spectroscopy in mild cognitive impairment: Systematic review and meta-analysis

• Published in: Neuroscience and biobehavioral reviews Vol. 37; no. 10; pp. 2571 - 2586
• Main Authors: TUMATI, Shankar, MARTENS, Sander, ALEMAN, André
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier 01.12.2013
• Subjects: Adult and adolescent clinical studies; Aspartic Acid - analogs & derivatives; Aspartic Acid - metabolism; Behavioral psychophysiology; Biological and medical sciences; Choline - metabolism; Cognitive Dysfunction - metabolism; Cognitive Dysfunction - pathology; Creatine - metabolism; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Fundamental and applied biological sciences. Psychology; Geriatrics; Humans; Inositol - metabolism; Magnetic Resonance Spectroscopy - methods; Medical sciences; Neurology; Organic mental disorders. Neuropsychology; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Psychopathology. Psychiatry; Choleretic; Cognitive disorder; Alzheimer disease; Central nervous system; Mild Cognitive Impairment (MCI); B-Vitamins; Review; Paratrigonal white matter; Creatine; Encephalon; Metaanalysis; Posterior cingulate; Cingulate cortex; Creatine (Cr); Choline (Cho); Degenerative disease; Nervous system diseases; Inositol; Alzheimer's Disease (AD); Magnetic resonance; Aspartate; White matter; Cerebral disorder; Magnetic Resonance Spectroscopy (MRS); Choline; Central nervous system disease; Excitatory aminoacid; Neurotransmitter; Myo-inositol (mI); N-Acetyl Aspartate (NAA); mild cognitive impairment; Hippocampus
• ISSN: 0149-7634; 1873-7528
• DOI: 10.1016/j.neubiorev.2013.08.004

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.