Characterization of cerebral small vessel disease by proton spectroscopy and morphological magnetic resonance

This study sought to investigate whether clinical and neuropsychological im pairment in cerebral small vessel disease (CSVD) can be evaluated by proton spectroscopy (H-1-MRS) and structural magnetic resonance (MR) imaging. Six teen patients with CSVD and 15 healthy age-matched controls participated in the study. In addition to spectroscopic and structural MR examination all patients underwent a comprehensive clinical and neuropsychological investig ation. Significant differences in between patients and controls were reveal ed by 1H-MRS in the parietal white matter: decreased metabolic ratios of N- acetyl aspartate to choline (NAA/Cho; patients: 1.37 +/- 0.17, control: 1.7 2 +/- 0.25, p < 0.001) and of N-acetyl aspartate to creatin (NAA/Cr; patien ts: 1.41 +/- 0.15, control: 1.66 +/- 0.2, p < 0.01) indicated a pathologica l state. Evaluation of spectroscopic and neuro psychological data revealed a close relation between attentional impairment, i.e. delayed cerebral tran smission time and decreased NAA/Cho and NAA/Cr (r = 0.62, p = 0.014). In su m, 1H-MRS allowed a clear discrimination between patients with CSVD and age -matched normal controls. Moreover, comparisons of H-1-MRS and neuropsychol ogical data suggested that NAA metabolic levels, and particularly the delay in cerebral transmission time, could be potential predictors of the severe ness of attentional impairment. Copyright (C) 2001 S. Karger AG, Basel.