[2014-6] Waragai, M. et al., J. Alzheimer’s Dis. 41, 1207-1222 (2014)

We validated the utility of SPM8 plus DARTEL (VSRAD) combined with magnetic resonance spectroscopy (¹H MRS) as an adjunct screening technique for dementia due to Alzheimer’s disease (AD). We examined the posterior cingulate gyri of 228 subjects using VSRAD and ¹H MRS in addition to conventional cerebrospinal fluid biomarkers at baseline. At the 3-year follow-up, the 228 subject were classified as follows: 93 healthy subjects, 42 MCI-non-converters (MCI-NC), 25 MCI-converters to AD (MCI-C), 44 AD, 8 dementia with Lewy bodies (DLB), 5 normal pressure hydrocephalus, and 11 patients with other neurological diseases. Our results demonstrated that subjects with increased medial temporal atrophy (MTA) severity on VSRAD, increased Cho/Cr, MI/Cr ratio, and decreased NAA/Cr and NAA/MI ratio on ¹H MRS at baseline were at risk of dementia due to AD. Receiver operating characteristic analysis showed that severity of MTA and the NAA/MI ratio distinguished patients with AD and MCI-C from controls. Furthermore, the 118 subjects without dementia and MTA showing only a decreased NAA/MI ratio at baseline developed to MCI-C, AD, and DLB 3 years later. ¹H MRS detected biochemical abnormalities preceding brain atrophy and cognitive decline. VSRAD combined with ¹H MRS may be routinely applied to screen for MCI/AD and prodromal AD in clinical practice.