Magnetic resonance spectroscopy as a predictor of conversion of mild cognitive impairment to dementia.

Background And Purpose: Proton magnetic resonance spectroscopy ((1)H-MRS) is one of the imaging techniques that could be potentially useful for identification of patients with mild cognitive impairment (MCI) who are at increased risk of developing dementia. The aim of the study was to investigate if there is a difference in brain metabolism between stable MCI patients and converters to dementia and if a use of (1)H-MRS can predict the conversion from MCI to dementia.

Material And Methods: Forty-one amnestic MCI patients and 35 cognitively unimpaired controls were examined by (1)H-MRS (TE - 35 ms) at baseline. Metabolite ratios (NAA/Cr, Cho/Cr, mI/Cr, Glx/Cr, NAA/Cho) were estimated in four different brain regions: posterior cingulate gyrus (PCG), left hippocampus (LH), cortical area of right (RPL) and left parietal lobe (LPL). Participants were followed up for a period of 12 months.

Results: Twelve subjects with MCI progressed to Alzheimer's disease (AD) after one year. Analysis showed that the NAA/Cr ratio in the LH was significantly lower in MCI patients than in controls (p=0.008), but there were no differences in metabolite ratios at baseline between MCI converters and stable subjects. mI/Cr ratio in RPL predicted the conversion to AD with sensitivity 70% and specificity 85% (p<0.0004). Coexistence of diabetes improved prediction, yielding 70% sensitivity and 96% specificity (p<0.0001).

Conclusions: (1)H-MRS in MCI can be a predictor of cognitive decline and conversion to dementia, especially in MCI patients with coexisting diabetes. Further studies are needed to confirm this finding.