Brain magnetic resonance spectroscopy - Role in assessing outcomes in Alzheimer's disease

Contemporary H-1-magnetic resonance spectroscopy (MRS) techniques can estim ate the levels of brain metabolites with a high reproducibility and add onl y 10 minutes to a routine or volumetric magnetic resonance imaging scan. In patients with Alzheimer's disease (AD), H-1-MRS demonstrates decreases in N-acetylaspartate (NAA) and increases in myo-inositol (Ino) levels. Changes in NAA and Ino levels correlate with dementia severity and may predict fut ure cognitive decline. H-1-MRS could be a valuable outcome measure in clini cal trials of individuals with AD for monitoring disease progression (using NAA and Ino levels) and evaluating therapeutic response to novel drugs (us ing NAA, choline and Ino levels). Further studies are warranted to evaluate the relative utility of H-1-MRS compared with other imaging markers, such as cerebral blood flow and volumetric measures of atrophy. Protocols combin ing magnetic resonance perfusion, volumetry and spectroscopy in AD may prov e to be powerful research tools.