scholarly journals P1240EVALUATION OF COGNITIVE FUNCTION IN HEMODIALYSIS PATIENTS USING MAGNETIC RESONANCE SPECTROSCOPY: FIVE YEARS FOLLOW UP RESULTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Shigeru Owada ◽  
Aki Hirayama ◽  
Teruhiko Maeba
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Future Research ◽  
Resonance Spectroscopy ◽  
Brain Metabolites ◽  
Dialysis Patients ◽  
Cont Group ◽  
The Brain

Abstract Background and Aims In Japan, the elderly population is increasing remarkably, and dialysis patients are aging as usual. According to statistics from the Japanese Society for Dialysis Therapy, at the end of 2017, the incidence of HD patients is estimated to be 3 per 1,000 population, and by the end of 2020, the average age will be over 70 years. Therefore, early diagnosis of cognitive impairment is an important issue. With the aging of dialysis patients, the number of cases showing cognitive dysfunction increase in addition to the decline of physical strength. The problem of the onset of dementia involves many difficulties in medical treatment and nursing. Magnetic resonance spectroscopy (MRS) has been progressing from 1970s to evaluate neurological functions by measuring metabolites in the brain non-invasively. There are few reports using MRS for dialysis patients. In this study, we investigated the brain metabolites of hemodialysis (HD) patients with or without cognitive impairments using MRS and evaluated its usefulness for the diagnosis of cognitive disorder. Method A Toshiba MR device of 1.5 T was used. PRESS sequence was used to acquire water-suppressed 1H-MRS. Timing was TR/TE 2000/25 ms. Three kinds of brain metabolites, namely N-acethylaspartate (NAA), creatine (Cr) and mioinositol (MI) in the posterior cingulate gyrus were measured for 25 healthy adults (Cont group, 44±16 y.o.) and 84 HD patients (HD group, 74±11 y.o.), and ratios of NAA/Cr, MI/Cr and MI/NAA were calculated. The concentration of each metabolite was analyzed using LC model. HD patients were classified into three groups, namely normal cognitive function group (HD-N, n=25, 72±16 y.o.), mild cognitive impairment (HD-M, n=29, 74±9 y.o.) and dementia (HD-D, n=30, 79±8 y.) using MMSE test. Also, sequential changes of the brain metabolites were evaluated for 13 patients with worse cognitive function prospectively. Results HD patients showed a significant decrease of NAA and increases of MI and MI/NAA ratios compared to those of Cont group, suggesting that some metabolic abnormalities were inducted in HD. With a detailed classification of cognitive function in HD patients, NAA/Cr ratios were 1.69±0.17, 1.57±0.15, 1.71±0.20 and 1.54±0.22 in Cont, HD-N, HD-M and HD-D groups, respectively, and was significantly lower even in HD-N group than that of Cont group. MI/Cr ratios were 0.78±0.21, 0.90±0.21, 0.95±0.28 and 1.02±0.27 in Cont, HD-N, HD-M and HD-D groups, respectively, and those of HD-N/-M/-D were significantly higher than that of Cont group. Also, the value of HD-D was significantly higher than those in the other groups. MI/NAA ratios were 0.46±0.13, 0.56±0.17, 0.54±0.16 and 0.66±0.15, in Cont, HD-N, HD-M and HD-D groups, respectively. Again, those of HD-N/-M/-D were significantly higher than that of Cont group. HD-D group was highest among the HD patients. In the prospective study, dementia progressed in 10 of 13 HD patients who were observed more than 5 years. The MI/NAA ratio increased in the patients with dementia progression (from 0.58±0.11 to 1.24±0.17) while that value of the patients without dementia progression showed no changes (from 0.51±0.14 to 0.55±0.18). Conclusion These result suggest that the measurement of metabolic fluctuation in the brain using MRS is useful for the diagnosis of cognitive function in HD patients. The MI/NAA value is a strong candidate for a predictive biomarker of dementia progression. In the future, research and development of measurements of various parts of the brain and their integration to show changes in the whole brain are desired.

Longitudinal Functional Magnetic Resonance Spectroscopy Study in Subjects with Mild Cognitive Impairment and Alzheimer’s Disease

2021 ◽  
Vol 18 ◽  
Author(s):  
Soo-Hyun Cho ◽  
Hak Young Rhee ◽  
Janghoon Oh ◽  
Jin San Lee ◽  
Soonchan Park ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Resonance Spectroscopy ◽  
Brain Metabolites ◽  
Functional Magnetic Resonance ◽  
Longitudinal Changes ◽  
Functional Magnetic Resonance Spectroscopy

Background: Longitudinal changes of brain metabolites during a functional stimulation are unknown in amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease (AD) subjects. Objective: This study was to evaluate the longitudinal changes of brain metabolites using proton magnetic resonance spectroscopy (1H MRS) in response to treatment during a memory task in the subjects of cognitive normal (CN), aMCI, and AD. Methods: We acquired functional magnetic resonance spectroscopy (fMRS) data from 28 CN elderly, 16 aMCI and 12 AD subjects during a face-name association task. We measured fMRS metabolite ratios over 24 months in the 8-month apart, determined the temporal changes of the metabolites, and evaluated the differences among the three groups under the three different conditions (base, novel, repeat). Results: The results of comparisons for the three subject groups and the three-time points showed that tNAA/tCho and tCr/tCho were statistically significant among the three subject groups in any of the three conditions. The dynamic temporal change measurements for the metabolites for each condition showed that Glx/tCho and Glu/tCho levels at the third visit increased significantly compared with in the first visit in the novel condition in the AD group. Conclusion: We found declines in tNAA/tCho and tCr/tCho in the aMCI and AD subjects with increasing disease severity, being highest in CN and lowest in AD. The Glx/tCho level increased temporally in the AD subjects after they took an acetylcholine esterase inhibitor. Therefore, Glx may be suitable to demonstrate functional recovery after treatment.

scholarly journals 1H magnetic resonance spectroscopy, cognitive function, and apolipoprotein E genotype in normal aging, mild cognitive impairment and Alzheimer's disease

2002 ◽  
Vol 8 (7) ◽  
pp. 934-942 ◽  
Author(s):  
KEJAL KANTARCI ◽  
GLENN E. SMITH ◽  
ROBERT J. IVNIK ◽  
RONALD C. PETERSEN ◽  
BRADLEY F. BOEVE ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Apolipoprotein E ◽  
Verbal Learning ◽  
Apoe Genotype ◽  
Cognitive Test ◽  
Resonance Spectroscopy

The aim of this study was to examine the associations of apolipoprotein E (APOE) genotype, metabolic changes in the posterior cingulate detected by 1H magnetic resonance spectroscopy (MRS), and neuropsychologic measures of memory and cognition both in normally aging elderly, and in patients with mild cognitive impairment (MCI) and AD. We studied 67 controls, 18 MCI and 33 AD patients. We used the Dementia Rating Scale total score (DRSTOT) as a measure of general cognitive function and the total learning from the Auditory Verbal Learning Test (AVTOT) as a measure of memory performance. No differences were noted on 1H-MRS metabolite ratios or cognitive measures across APOE genotype within control and patient groups. In controls, age was a significant predictor of both cognitive test scores, and NAA/Cr was a univariate associate of DRSTOT. All 3 1H-MRS metabolite ratios, N-acetylaspartate (NAA)/creatine (Cr), myoinositol (MI)/Cr, and NAA/MI, were univariate associates of AVTOT and DRSTOT scores in the combined MCI and AD group. In stepwise regression analyses in the combined patient group only NAA/MI entered the models. These data suggest NAA/Cr could be a modest predictor of general cognitive function in both healthy elderly and impaired patients, while MI/Cr is a more specific marker for neuropsychologic dysfunction associated with neurodegenerative disease. Among 1H-MRS measurements, the NAA/MI ratio maybe the most efficient predictor of memory and cognitive function in patients with MCI and AD. (JINS, 2002, 8, 934–942.)

Alterations of Brain Metabolites in Adults With HIV: A Systematic Meta-analysis of Magnetic Resonance Spectroscopy Studies

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012394
Author(s):  
Sophia Dahmani ◽  
Nicholas Kaliss ◽  
John W. VanMeter ◽  
David J Moore ◽  
Ronald J. Ellis ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Basal Ganglia ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Meta Analysis ◽  
Brain Regions ◽  
Resonance Spectroscopy ◽  
Signal Pathways ◽  
Brain Metabolites

Objective.A meta-analysis of proton magnetic resonance spectroscopy (MRS) studies to investigate alterations in brain metabolites in people with HIV (PWH), as well as their relationship with combination antiretroviral therapy (cART) and cognitive impairment.Methods.The PubMed database was searched for studies published from 1997 to 2020. Twenty-seven studies were identified, which included 1255 PWH and 633 controls. Four metabolites (N-acetyl aspartate (NAA), myo-Inositol (mI), choline (Cho), and glutamatergic metabolites (Glx) from five brain regions (basal ganglia (BG), frontal gray and white matter (FGM, FWM), and parietal gray and white matter (PGM, PWM)) were pooled separately using random-effects meta-analysis.Results.During early HIV infection, metabolite alterations were largely limited to the BG, including Cho elevation, a marker of inflammation. cART led to global mI and Cho normalization (i.e., less elevations), but improvement in NAA was negligible. In chronic PWH on cART, there were consistent NAA reductions across brain regions, along with Cho and mI elevations in the FWM and BG, and Glx elevations in the FWM. Cognitive impairment was associated with NAA reduction and to a lesser degree, mI elevation.Conclusions.The basal ganglia is the primary region affected during early infection. cART is successful in partially controlling neuroinflammation (global mI and Cho normalization). However, neuronal dysfunction (NAA reductions) and neuroinflammation (mI and Cho elevations) persist and contribute to cognitive impairment in chronic PWH. Novel compounds targeting NAA signal pathways, along with better neuroinflammation control, may help to reduce cognitive impairment in PWH.

scholarly journals Changes in metabolites in the brain of patients with fibromyalgia after treatment with an NMDA receptor antagonist

2019 ◽  
Vol 32 (6) ◽  
pp. 408-419 ◽  
Author(s):  
Nicolas Fayed ◽  
Barbara Oliván ◽  
Yolanda Lopez del Hoyo ◽  
Eva Andrés ◽  
Mari Cruz Perez-Yus ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Clinical Global Impression ◽  
Anterior Insula ◽  
Resonance Spectroscopy ◽  
Posterior Cingulate ◽  
Posterior Insula ◽  
The Right ◽  
The Brain

The aims of this work were to evaluate whether the treatment of patients with fibromyalgia with memantine is associated with significant changes in metabolite concentrations in the brain, and to explore any changes in clinical outcome measures. Magnetic resonance spectroscopy was performed of the right anterior and posterior insula, both hippocampi and the posterior cingulate cortex. Questionnaires on pain, anxiety, depression, global function, quality of life and cognitive impairment were used. Ten patients were studied at baseline and after three months of treatment with memantine. Significant increases were observed in the following areas: N-acetylaspartate (4.47 at baseline vs. 4.71 at three months, p = 0.02) and N-acetylaspartate+N-acetylaspartate glutamate in the left hippocampus (5.89 vs. 5.98; p = 0.007); N-acetylaspartate+N-acetylaspartate glutamate in the right hippocampus (5.31 vs 5.79; p = 0.01) and the anterior insula (7.56 vs. 7.70; p = 0.033); glutamate+glutamine/creatine ratio in the anterior insula (2.03 vs. 2.17; p = 0.022) and the posterior insula (1.77 vs. 2.00; p = 0.004); choline/creatine ratio in the posterior cingulate (0.18 vs. 0.19; p = 0.023); and creatine in the right hippocampus (3.60 vs. 3.85; p = 0.007). At the three-month follow-up, memantine improved cognitive function assessed by the Cognition Mini-Exam (31.50, SD = 2.95 vs. 34.40, SD = 0.6; p = 0.005), depression measured by the Hamilton Depression Scale (7.70, SD = 0.81 vs. 7.56, SD = 0.68; p = 0.042) and severity of illness measured by the Clinical Global Impression severity scale (5.79, SD = 0.96 vs. 5.31, SD = 1.12; p = 0.007). Depression, clinical global impression and cognitive function showed improvement with memantine. Magnetic resonance spectroscopy could be useful in monitoring response to the pharmacological treatment of fibromyalgia.

Cognitive Performance and Neuro-Metabolites in HIV using 3T Magnetic Resonance Spectroscopy: A Cross-Sectional Study from India

2020 ◽  
Vol 18 ◽  
Author(s):  
Kartik Gupta ◽  
Shivabalan ◽  
Virendra Kumar ◽  
Surabhi Vyas ◽  
RM Pandey ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Motor Skills ◽  
Cross Sectional Study ◽  
Resonance Spectroscopy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Total N ◽  
Simple Motor

Background: Cognitive impairment in patients with human immunodeficiency virus (HIV) is associated with higher morbidity. The prevalence of and the metabolite changes in the brain associated with cognitive impairment in anti-retroviral therapy naïve patients with HIV is unknown. Objective: To estimate the prevalence of, and the neurometabolites associated with cognitive impairment in antiretroviral therapy (ART) naïve patients with HIV. Methods: We conducted a cross-sectional study among ART naïve patients with HIV aged 18-50 years in a tertiary care center in India. Cognition was tested using the Post Graduate Institute battery of brain dysfunction across five domains; memory, attentioninformation processing, abstraction executive, complex perceptual, and simple motor skills. We assessed the total N-acetyl aspartyl (tNAA), creatine (tCr) and glutamate + glutamine (Glx) using 3T magnetic resonance spectroscopy. Cognitive impairment was defined as an impairment in ≥2 domains. Results: Among 43 patients eligible for this study, the median age was 32 years (IQR 29, 40) and 30% were women. Median CD4 count and viral load were 317 cells/µL (IQR 157, 456) and 9.3 copies/ µL (IQR 1.4, 38), respectively. Impairment in at least one cognitive domain was present in 32 patients (74.4%). Impairment in simple motor skills and memory was present in 46.5% and 44% of patients, respectively. Cognitive impairment, defined by impairment in ≥2 domains, was found in 22 (51.2%) patients. There was a trend towards higher concentration of tNAA (7.3 vs. 7.0 mmol/kg), tGlx (9.1 vs. 8.2 mmol/kg), and tCr (5.5 vs. 5.2 mmol/kg) in the frontal lobe of patients with cognitive impairment vs. without cognitive impairment but it did not reach statistical significance (p>0.05 for all). There was no difference in the concentration of these metabolites in the two groups in the basal ganglia. Conclusions: There is a high prevalence of cognitive impairment in ART naïve patients with HIV. There is no difference in metabolites in patients with or without cognitive impairment. Further studies, with longitudinal follow-up, are required to understand the underlying pathophysiological mechanisms.

Neurometabolic Diseases in Children: Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy Features

2019 ◽  
Vol 15 (3) ◽  
pp. 255-268
Author(s):  
Direnç Özlem Aksoy ◽  
Alpay Alkan
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Metabolic Pathways ◽  
Wide Spectrum ◽  
Demyelinating Diseases ◽  
Resonance Spectroscopy ◽  
Resonance Imaging ◽  
Neurometabolic Disorders ◽  
Brain Involvement ◽  
The Brain

Background: Neurometabolic diseases are a group of diseases secondary to disorders in different metabolic pathways, which lead to white and/or gray matter of the brain involvement. </P><P> Discussion: Neurometabolic disorders are divided in two groups as dysmyelinating and demyelinating diseases. Because of wide spectrum of these disorders, there are many different classifications of neurometabolic diseases. We used the classification according to brain involvement areas. In radiological evaluation, MRI provides useful information for these disseases. Conclusion: Magnetic Resonance Spectroscopy (MRS) provides additional metabolic information for diagnosis and follow ups in childhood with neurometabolic diseases.

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