PROBABLE ALZHEIMER-DISEASE - DIAGNOSIS WITH PROTON MR SPECTROSCOPY

PURPOSE: To distinguish probable Alzheimer disease (AD) from other dem entias (ODs) and normality in the elderly. MATERIALS AND METHODS: A do uble-blind trial of proton magnetic resonance (MR) spectroscopy was pe rformed, principally in gray matter, in the occipital cortex of 114 pa tients with dementia (AD [n = 65], OD [n = 39], or frontal lobe dement ia [FLD] [n = 10]), 98 patients without dementia, and 32 healthy contr ol subjects. RESULTS: Reduced levels of N-acetylaspartate (NAA) (P <.0 005) and increased levels of myo-inositol (MI) (P <.0005) characterize AD. Patients with OD had significantly reduced levels of NAA (P <.01) but normal levels of MI (P [vs AD] <.0005). When MI/NAA was used, AD was distinguished from normality with 83% sensitivity and 98% specific ity. When MI/creatine was used, OD was distinguished from AD and FLD w ith a negative predictive rate of 80%, sensitivity of 82%, and specifi city of 64%. CONCLUSION: Hydrogen-1 MR spectroscopy enables identifica tion of mild to moderate AD with a specificity and sensitivity that su ggest clinical utility.