CHANGES IN BRAIN MEMBRANE PHOSPHOLIPID AND HIGH-ENERGY PHOSPHATE-METABOLISM PRECEDE DEMENTIA

A 52-year-old Caucasian male was followed with Mattis and P-31 MRS exa minations every 6 months for 33 months. At entry into the study, the s ubject had a normal clinical examination and normal Mattis scores but had alterations in MRS measures of membrane phospholipid and high-ener gy phosphate metabolism indistinguishable from those previously report ed in mildly demented AD patients. After 33 months of follow-up, the s ubject had clinical and Mattis findings suggestive of possible incipie nt dementia and after 46 months of follow-up there was sufficient cogn itive decline to make the diagnosis of dementia with a frontal lobe pr eponderance. The findings in this subject support the contention that alterations in brain membrane phospholipid and high-energy metabolism can be noninvasively detected by P-31 MRS years before any clinical ma nifestations of the disease.