D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil.
Dement Geriatr Cogn Disord. 2011;32(5):351-61. doi: 10.1159/000334656. Epub 2012 Feb 3.
BACKGROUND/AIMS: The diagnosis of mild or questionable Alzheimer's disease (AD) depends on clinical criteria that often leave a margin for doubt. We aim to verify the diagnostic accuracy of amnestic mild cognitive impairment (aMCI) and AD with proton spectroscopy (1H-MRS) combined with brief cognitive-functional scales.
The relationship between 1H-MRS of the posterior cingulate cortex and the cognitive performance in Mini Mental State Examination, Blessed-Roth Dementia Rating and Functional Assessment Staging of Alzheimer Disease scales were investigated in 25 AD, 10 aMCI and 33 normal control (NC) individuals.
The N-acetylaspartate (NAA)/creatine and myoinositol/NAA ratios distinguished AD patients from NC (p<0.005), and added value in diagnostic accuracy and specificity by discriminant function analysis when combined to clinical diagnosis and simple neuropsychiatric scales; an increase of 3.7% (for aMCI patients) and of 5% (for AD individuals) was observed in diagnostic accuracy, and one of 5.5% (aMCI) and of 11.1% (AD) in specificity.
1H-MRS combined with brief cognitive-functional scales provided maximum diagnostic accuracy of AD patients, and can be useful when subtle cognitive and memory dysfunction is present.
背景/目的：轻度或可疑阿尔茨海默病（AD）的诊断取决于临床标准，这些标准常常存在一定的疑问空间。我们旨在通过质子波谱（1H-MRS）结合简要的认知功能量表来验证遗忘型轻度认知障碍（aMCI）和 AD 的诊断准确性。
我们研究了 25 例 AD、10 例 aMCI 和 33 例正常对照（NC）个体的后扣带回皮质的 1H-MRS 与简易精神状态检查（Mini Mental State Examination）、Blessed-Roth 痴呆评定量表和阿尔茨海默病功能评估分期量表的认知表现之间的关系。
N-乙酰天门冬氨酸（NAA）/肌酸和肌醇/NAA 比值可将 AD 患者与 NC 患者区分开来（p<0.005），并且通过判别函数分析结合临床诊断和简单的神经精神病量表，在诊断准确性和特异性方面具有附加价值；诊断准确性增加了 3.7%（aMCI 患者）和 5%（AD 个体），特异性增加了 5.5%（aMCI）和 11.1%（AD）。
1H-MRS 结合简要的认知功能量表可提供 AD 患者的最大诊断准确性，并且在存在轻微认知和记忆功能障碍时可能会很有用。
