In vivo mr spectroscopy usefulness in the diagnosis and monitoring of neurodegenerative disorders

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Ángela Bernabeua,d, Jaume Morerab, Serna-Candel C c, Martín-Estefanía C c, Martí Sc, Turpín Lc y Frutos-Alegría T b,c.
a Universidad Miguel Hernández de Elche,, b Centro de Diagnóstico Precoz de la Enfermedad de Alzheimer (CDP-ALZ San Vicente). Hospital San Vicente. San Vicente, c Servicio de Neurología. Hospital General Universitario de Alicante, d Unidad de Resonancia Magnética. INSCANNER. Alicante.

Proton magnetic resonance spectroscopy (1H-MRS) has been proposed in conjunction with MR imaging as a method for the evaluation of patients with neurological disorders. There is a substantial body of literature dealing with predictors including the MR spectroscopy in patients with Alzheimer disease (AD) and Amyotrophic Lateral Sclerosis (ALS). These predictors range from a simple delayed recall task on Mini-Mental to sophisticated radiological techniques and CSF biomarkers. Noninvasive markers of disease progression starting from the earliest stages of pathologic involvement are required for determining the evolution and effectiveness of putative disease-modifying therapies that are under development. The 1HMRS provides a noninvasive way to investigate in vivo neurochemical abnormalities providing potentially information about unique in vivo pathological processes at the molecular or cellular level. The aim of this work was to analyze the predictive value and the usefulness of the MRS in the study and monitoring of two neurodegenerative diseases: the AD and the ALS. With this purpose two different protocols were performed combining physical, specific psychological test, MRI studies and MRS analyses. For the MR spectroscopy studies the brain regions analyzed were specific for each disease and chosen according to literature. Standard ratios of N-acetyl-aspartate/Creatine (NAA/Cr), Glutamate-Glutamine/Creatine (Glx/Cr), Choline/Creatine (Cho/Cr) and Mioinositol/Creatine were calculated by SVS exam in a 1.5T scanner. The spectroscopy data statistical analyses obtained in both cases presented a good correlation with the clinical findings. The results obtained allowed us to generate a more sensitive protocol than the standard MR imaging findings in the detection of both neurological disorders, as well as determine different brain areas implicated in the ALS.

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