Magnetic resonance spectroscopy in Alzheimer's disease: focus on N-acetylaspartate

This paper reviews published post-mortem brain and in-vivo proton magnetic resonance spectroscopy (H-1-MRS) studies in Alzheimer's disease (AD) and fo cuses on the emerging role of N-acetylaspartate (NAA) as a prognostic marke r of neuronal function. Post-mortem brain studies have reported significant ly lower NAA levels in AD brains than in control brains, and some have corr elated the low levels with neuropathological findings (i.e. amyloid plaques and neurofibrillary tangles). Similarly, almost all published in-vivo stud ies have reported lower NAA levels in AD patients compared to elderly contr ols. While some studies have found changes in metabolite levels that were c onsidered useful for the diagnosis of AD, most have found that H-1-MRS prov ided little or no advantages over other, more common diagnostic tools. Inst ead, recent studies in AD and other neuropsychiatric disorders suggest that NAA may be more useful as a prognostic marker for monitoring neurodegenera tion. stabilization, or improvement, and for evaluating therapeutic respons e to novel drugs.