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Griffith HR, Okonkwo OC, Stewart CC, Stoeckel LE, den Hollander JA, Elgin JM, Harrell LE, Brockington JC, Clark DG, Ball KK, Owsley C, Marson DC, Wadley VG. Lower hippocampal volume predicts decrements in lane control among drivers with amnestic mild cognitive impairment. J Geriatr Psychiatry Neurol 2013; 26:259-66. [PMID: 24212246 PMCID: PMC4114386 DOI: 10.1177/0891988713509138] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES There are few methods to discern driving risks in patients with early dementia and mild cognitive impairment (MCI). We aimed to determine whether structural magnetic resonance imaging (MRI) of the hippocampus-a biomarker of probable Alzheimer pathology and a measure of disease severity in those affected--is linked to objective ratings of on-road driving performance in older adults with and without amnestic MCI. METHODS In all, 49 consensus-diagnosed participants from an Alzheimer's Disease Research Center (15 diagnosed with amnestic MCI and 34 demographically similar controls) underwent structural MRI and on-road driving assessments. RESULTS Mild atrophy of the left hippocampus was associated with less-than-optimal ratings in lane control but not with other discrete driving skills. Decrements in left hippocampal volume conferred higher risk for less-than-optimal lane control ratings in the patients with MCI (B = -1.63, standard error [SE] = .74, Wald = 4.85, P = .028), but not in controls (B = 0.13, SE = .415, Wald = 0.10, P = .752). The odds ratio and 95% confidence interval for below-optimal lane control in the MCI group was 4.41 (1.18-16.36), which was attenuated to 3.46 (0.88-13.60) after accounting for the contribution of left hippocampal volume. CONCLUSION These findings suggest that there may be a link between hippocampal atrophy and difficulties with lane control in persons with amnestic MCI. Further study appears warranted to better discern patterns of brain atrophy in MCI and Alzheimer disease and whether these could be early markers of clinically meaningful driving risk.
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Affiliation(s)
- H Randall Griffith
- Departments of Neurology, University of Alabama at Birmingham, AL,Departments of Psychology, University of Alabama at Birmingham, AL,Alzheimer's Disease Research Center, University of Alabama at Birmingham, AL
| | - Ozioma C Okonkwo
- Department of Medicine and Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI
| | | | - Luke E Stoeckel
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | | | - Jennifer M Elgin
- Departments of Opthalmology, University of Alabama at Birmingham, AL,Edward R. Roybal Center for Translational Research on Aging and Mobility, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lindy E Harrell
- Departments of Neurology, University of Alabama at Birmingham, AL,Alzheimer's Disease Research Center, University of Alabama at Birmingham, AL,Birmingham Regional Veterans Affairs Medical Center, Birmingham, AL, USA
| | - John C Brockington
- Departments of Neurology, University of Alabama at Birmingham, AL,Alzheimer's Disease Research Center, University of Alabama at Birmingham, AL
| | - David G Clark
- Departments of Neurology, University of Alabama at Birmingham, AL,Alzheimer's Disease Research Center, University of Alabama at Birmingham, AL,Birmingham Regional Veterans Affairs Medical Center, Birmingham, AL, USA
| | - Karlene K Ball
- Departments of Psychology, University of Alabama at Birmingham, AL,Alzheimer's Disease Research Center, University of Alabama at Birmingham, AL,Edward R. Roybal Center for Translational Research on Aging and Mobility, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Cynthia Owsley
- Departments of Opthalmology, University of Alabama at Birmingham, AL,Edward R. Roybal Center for Translational Research on Aging and Mobility, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Daniel C Marson
- Departments of Neurology, University of Alabama at Birmingham, AL,Alzheimer's Disease Research Center, University of Alabama at Birmingham, AL
| | - Virginia G Wadley
- Departments of Medicine, University of Alabama at Birmingham, AL,Alzheimer's Disease Research Center, University of Alabama at Birmingham, AL,Edward R. Roybal Center for Translational Research on Aging and Mobility, University of Alabama at Birmingham, Birmingham, AL, USA
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Stoeckel LE, Stewart CC, Griffith HR, Triebel K, C. Okonkwo O, den Hollander JA, Martin RC, Belue K, Copeland JN, Harrell LE, Brockington JC, Clark DG, Marson DC. MRI volume of the medial frontal cortex predicts financial capacity in patients with mild Alzheimer's disease. Brain Imaging Behav 2013; 7:282-92. [PMID: 23504597 PMCID: PMC3716854 DOI: 10.1007/s11682-013-9226-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Persons with mild Alzheimer's disease (AD) have significant deficits in financial abilities. This study examined the relationship between brain structure volumes, cognition, and financial capacity in patients with mild AD. Sixteen mild AD patients and 16 older adult comparisons completed the Financial Capacity Instrument (FCI), a psychometric measure of financial abilities, and also underwent magnetic resonance imaging (MRI) to obtain volumes of the bilateral hippocampi, angular gyri, precunei, and medial and dorsolateral frontal cortices. Mild AD patients performed significantly below comparisons on the FCI and had significantly smaller hippocampi. Among mild AD patients, FCI performance was moderately correlated with frontal (medial and dorsolateral frontal cortex) and posterior (angular gyri and precunei) cortical volumes. Stepwise regression demonstrated that medial frontal cortex volume predicted FCI score. The relationship between medial frontal cortex volume and overall FCI score was partially mediated by two measures of simple attention (DRS Attention, DRS Construction). The findings suggest that medial frontal cortex atrophy and associated declines in simple attention play an increasingly important role in declining financial skills in patients with mild AD.
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Affiliation(s)
- Luke E. Stoeckel
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | | | | | - Kristen Triebel
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
- Department of Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, AL
| | - Ozioma C. Okonkwo
- Department of Medicine & Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI
| | | | - Roy C. Martin
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
- Department of Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, AL
| | - Katherine Belue
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
- Department of Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, AL
| | | | - Lindy E. Harrell
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
- Department of Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, AL
- Birmingham Regional Veterans Affairs Medical Center, Birmingham, AL
| | - John C. Brockington
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
- Department of Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, AL
| | - David G. Clark
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
- Department of Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, AL
- Birmingham Regional Veterans Affairs Medical Center, Birmingham, AL
| | - Daniel C. Marson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
- Department of Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, AL
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Reid MA, Kraguljac NV, Avsar KB, White DM, den Hollander JA, Lahti AC. Proton magnetic resonance spectroscopy of the substantia nigra in schizophrenia. Schizophr Res 2013; 147:348-54. [PMID: 23706412 PMCID: PMC3760722 DOI: 10.1016/j.schres.2013.04.036] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 04/24/2013] [Accepted: 04/26/2013] [Indexed: 01/09/2023]
Abstract
BACKGROUND Converging evidence in schizophrenia points to disruption of the dopamine and glutamate neurotransmitter systems in the pathophysiology of the disorder. Dopamine is produced in the substantia nigra, but few neuroimaging studies have specifically targeted this structure. In fact, no studies of the substantia nigra in schizophrenia have used proton magnetic resonance spectroscopy (MRS). We sought to demonstrate the feasibility of acquiring single-voxel MRS measurements at 3T from the substantia nigra and to determine which metabolites could be reliably quantified in schizophrenia patients and healthy controls. METHODS We used a turbo spin echo sequence with magnetization transfer contrast to visualize the substantia nigra and single-voxel proton MRS to quantify levels of N-acetylaspartate, glutamate and glutamine (Glx), and choline in the left substantia nigra of 35 people with schizophrenia and 22 healthy controls. RESULTS We obtained spectra from the substantia nigra and quantified neurometabolites in both groups. We found no differences in levels of N-acetylaspartate/creatine, Glx/creatine, or choline/creatine between the groups. We found a significant correlation between Glx/creatine and overall cognitive performance, measured with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), in controls but not patients, a difference that was statistically significant. CONCLUSIONS Our study demonstrates the feasibility of obtaining single-voxel MRS data from the substantia nigra in schizophrenia. Such measurements may prove useful in understanding the biochemistry underlying cellular function in a region implicated in the pathophysiology of schizophrenia.
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Affiliation(s)
- Meredith A. Reid
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA,Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nina V. Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kathy B. Avsar
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA,Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David M. White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Adrienne C. Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA,To whom correspondence should be addressed: Adrienne C. Lahti, MD, Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, SC 501, 1720 2nd Ave S, Birmingham, AL 35294-0017, +1 205-996-6776, Fax: +1 205-975-4879,
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Bolding MS, Reid MA, Avsar KB, Roberts RC, Gamlin PD, Gawne TJ, White DM, den Hollander JA, Lahti AC. Magnetic transfer contrast accurately localizes substantia nigra confirmed by histology. Biol Psychiatry 2013; 73:289-94. [PMID: 22981657 PMCID: PMC3534824 DOI: 10.1016/j.biopsych.2012.07.035] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 06/13/2012] [Accepted: 07/30/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) has multiple contrast mechanisms. Like various staining techniques in histology, each contrast type reveals different information about the structure of the brain. However, it is not always clear how structures visible in MRI correspond to structures previously identified by histology. The purpose of this study was to determine if magnetic transfer contrast (MTC) or T2 contrast MRI was better at delineating the substantia nigra (SN). METHODS MRI scans were acquired in vivo from two nonhuman primates (NHPs). The NHPs were subsequently euthanized, perfused, and their brains sectioned for histologic analyses. Each slice was photographed before sectioning. Each brain was sectioned into approximately 500 sections, 40 μm each, encompassing most of the cortex, midbrain, and dorsal parts of the hindbrain. Levels corresponding to anatomic MRI images were selected. From these, adjacent sections were stained using Kluver-Barrera (myelin and cell bodies) or tyrosine hydroxylase (dopaminergic neurons) immunohistochemistry. The resulting images were coregistered to the block-face images using a moving least squares algorithm with similarity transformations. MR images were similarly coregistered to the block-face images, allowing the structures on MRI to be identified with structures on the histologic images. RESULTS We found that hyperintense (light) areas in MTC images were coextensive with the SN as delineated histologically. The hypointense (dark) areas in T2-weighted images were not coextensive with the SN but extended partially into the SN and partially into the cerebral peduncles. CONCLUSIONS MTC is more accurate than T2-weighting for localizing the SN in vivo.
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Affiliation(s)
| | | | | | | | - Paul D. Gamlin
- Vision Sciences, University of Alabama at Birmingham (UAB)
| | | | | | | | - Adrienne C. Lahti
- Psychiatry and Behavioral Neurobiology, UAB
,Corresponding author. Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, SC 501, 1530 3rd Avenue South, Birmingham, AL 35294-0017, United States. Tel.: +1 205 996 6776; fax: +1 205 975 4879.
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Reid MA, Stoeckel LE, White DM, Avsar KB, Bolding MS, Akella NS, Knowlton RC, Hollander JAD, Lahti AC. Assessments of function and biochemistry of the anterior cingulate cortex in schizophrenia. Biol Psychiatry 2010; 68:625-33. [PMID: 20570244 PMCID: PMC2953853 DOI: 10.1016/j.biopsych.2010.04.013] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 03/24/2010] [Accepted: 04/13/2010] [Indexed: 12/30/2022]
Abstract
BACKGROUND Neuroimaging and electrophysiologic studies have consistently provided evidence of impairment in anterior cingulate cortex/medial frontal cortex function in people with schizophrenia. In this study, we sought to clarify the nature of this abnormality by combining proton magnetic resonance spectroscopy (1H-MRS) with functional magnetic resonance imaging (fMRI) at 3T. METHODS We used single-voxel MRS acquired in the dorsal anterior cingulate cortex and fMRI during performance of a Stroop color-naming task to investigate the neurochemistry and functional response of the anterior cingulate cortex/medial frontal cortex in 26 stable, medicated subjects with schizophrenia and 23 matched healthy control subjects. RESULTS In schizophrenia subjects, we found decreased blood oxygen level-dependent signal in the medial frontal wall, with significant clusters restricted to more dorsal regions compared with healthy subjects. In addition, we observed a trend-level decrease in N-acetylaspartate/creatine (NAA/Cr) levels and a significant positive correlation between NAA/Cr level and the blood oxygen level-dependent signal in schizophrenia subjects that did not exist in healthy subjects. Furthermore, in this group of medicated subjects, we did not find evidence of decreased glutamate + glutamine(Glx)/Cr levels, but there was a significant negative correlation between Glx/Cr levels and negative symptoms. CONCLUSIONS Our results suggest that abnormal NAA levels, which may reflect a neuronal dysfunction related to schizophrenia, affect neuronal physiology, as evidenced by reduced blood oxygen level-dependent response.
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Affiliation(s)
- Meredith A. Reid
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, AL, Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, AL
| | - Luke E. Stoeckel
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - David M. White
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, AL
| | - Kathy B. Avsar
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, AL, Department of Psychology, The University of Alabama at Birmingham, Birmingham, AL
| | - Mark S. Bolding
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, AL, Department of Vision Sciences, The University of Alabama at Birmingham, Birmingham, AL
| | | | - Robert C. Knowlton
- Department of Neurology, The University of Alabama at Birmingham, Birmingham, AL
| | | | - Adrienne C. Lahti
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, AL
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Griffith HR, Okonkwo OC, den Hollander JA, Belue K, Copeland J, Harrell LE, Brockington JC, Clark DG, Marson DC. Brain metabolic correlates of decision making in amnestic mild cognitive impairment. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2010; 17:492-504. [PMID: 20373179 DOI: 10.1080/13825581003646135] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Persons with amnestic mild cognitive impairment (MCI) have subtle impairments in medical decision-making capacity (MDC). We examined the relationship between proton magnetic resonance spectroscopy (MRS) and MDC in MCI. Twenty-nine MCI patients and 42 controls underwent MRS to obtain ratios of N-acetylaspartate (NAA)/Creatine (Cr), Choline (Cho)/Cr, and myo-Inositol (mI)/Cr of the posterior cingulate. They also completed the Capacity to Consent to Treatment Instrument (CCTI), a vignette-based instrument measuring decisional standards of expressing choice, appreciating consequences of choice, providing rational reasons for choice, and understanding treatment choices. Patients showed abnormal MRS ratios of mI/Cr and Cho/Cr compared to controls, and impairments on the CCTI understanding and reasoning Standards. Performance on the reasoning standard of the CCTI was correlated with NAA/Cr (r = .46, p < .05). The relationship of NAA/Cr with decision-making suggests a role for posterior cortical neuronal functioning in performance of complex IADLs in MCI.
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Affiliation(s)
- H Randall Griffith
- Departments of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
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Griffith HR, Stewart CC, Stoeckel LE, Okonkwo OC, den Hollander JA, Martin RC, Belue K, Copeland JN, Harrell LE, Brockington JC, Clark DG, Marson DC. Magnetic resonance imaging volume of the angular gyri predicts financial skill deficits in people with amnestic mild cognitive impairment. J Am Geriatr Soc 2010; 58:265-74. [PMID: 20374402 DOI: 10.1111/j.1532-5415.2009.02679.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To better understand how brain atrophy in amnestic mild cognitive impairment (MCI) as measured using magnetic resonance imaging (MRI) volumetrics could affect instrumental activities of daily living (IADLs) such as financial abilities. DESIGN Controlled, matched-sample, cross-sectional analysis regressing MRI volumetrics with financial performance measures. SETTING University medical and research center. PARTICIPANTS Thirty-eight people with MCI and 28 older adult controls. MEASUREMENTS MRI volumetric measurement of the hippocampi, angular gyri, precunei, and medial frontal lobes. Participants also completed neuropsychological tests and the Financial Capacity Instrument (FCI). RESULTS Correlations were performed between FCI scores and MRI volumes in the group with MCI. People with MCI performed significantly below controls on the FCI and had significantly smaller hippocampi. Among people with MCI, performance on the FCI was moderately correlated with angular gyri and precunei volumes. Regression models demonstrated that angular gyrus volumes were predictive of FCI scores. Tests of mediation showed that measures of arithmetic and possibly attention partially mediated the relationship between angular gyrus volume and FCI score. CONCLUSION Impaired financial abilities in amnestic MCI correspond with volume of the angular gyri as mediated by arithmetic knowledge. The findings suggest that early neuropathology within the lateral parietal region in MCI leads to a breakdown of cognitive abilities that affect everyday financial skills. The findings have implications for diagnosis and clinical care of people with MCI and AD.
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Affiliation(s)
- H Randall Griffith
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
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Griffith HR, Stewart CC, den Hollander JA. Proton magnetic resonance spectroscopy in dementias and mild cognitive impairment. Int Rev Neurobiol 2009; 84:105-31. [PMID: 19501715 DOI: 10.1016/s0074-7742(09)00406-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
With the anticipated increase in dementias due to the aging demographic of industrialized nations, biomarkers for neurodegenerative diseases are increasingly important as new therapies are being developed for clinical trials. Proton MR spectroscopy ((1)H MRS) appears poised to be a viable means of tracking brain metabolic changes due to neurodegenerative diseases and potentially as a biomarker for treatment effects in clinical therapeutic trials. This review highlights the body of literature investigating brain metabolic abnormalities in Alzheimer's disease, amnestic mild cognitive impairment, frontotemporal dementia, vascular dementia, Lewy body dementia, and Parkinson's disease dementia. In particular, the review addresses the viability of (1)H MRS to discriminate among dementias, to measure disease progression, and to measure the effects of pharmacological treatments. While findings to date are encouraging, more study is needed in longitudinal patterns of brain metabolic changes, correspondence with changes in clinical markers of disease progression, and sensitivity of (1)H MRS measures to treatment effects. Such developments will hopefully benefit the search for effective treatments of dementias in the twenty-first century.
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Affiliation(s)
- H Randall Griffith
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama 35233, USA
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Griffith HR, den Hollander JA, Okonkwo OC, O'Brien T, Watts RL, Marson DC. Brain metabolism differs in Alzheimer's disease and Parkinson's disease dementia. Alzheimers Dement 2008; 4:421-7. [PMID: 19012867 DOI: 10.1016/j.jalz.2008.04.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2007] [Revised: 03/28/2008] [Accepted: 04/28/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Few comparative studies exist of metabolic brain changes among neurodegenerative illnesses. We compared brain metabolic abnormalities in Alzheimer's disease (AD) and in Parkinson's disease with dementia (PDD) as measured by proton magnetic resonance spectroscopy (MRS). METHODS Twelve patients with idiopathic PDD, 22 patients with probable mild AD, and 61 healthy older controls underwent posterior cingulate MRS. RESULTS Patients with AD exhibited reduced N-acetyl aspartate (NAA)/creatine (Cr) (P < .05) and increased choline (Cho)/Cr (P < .05) and myo-inositol (mI)/Cr (P < .01) compared with controls. Patients with PDD exhibited reduced NAA/Cr (P < .05) and glutamate (Glu)/Cr (P < .01) compared with controls. There was reduced Glu/Cr in PDD compared with AD (P < .01). CONCLUSIONS Patients with AD and patients with PDD exhibited distinct brain metabolic MRS profiles. Findings suggest that comparison of brain MRS profiles across dementias provides useful direction for future study.
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Affiliation(s)
- H Randall Griffith
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
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Abstract
An understanding of the role played by glutamate (Glu) in idiopathic Parkinson's disease (PD) has remained somewhat elusive. Animal models of PD suggest that over-activity of Glu receptors complicates the motor symptoms of PD and that Glu blockade may be a pharmacologic target in PD, whereas patient autopsy studies have proved less convincing for changes in Glu. No previous 1H MRS patient studies have documented changes in glutamate. All but one of these previous studies were performed at 1.5 T. We performed 3 T 1H MRS of the posterior cingulate gyrus in 12 non-demented patients with PD and 12 age-matched, neurologically normal control participants. Glu, N-acetylaspartate (NAA) and choline-containing compounds (Cho) measured in reference to creatine + phosphocreatine (Cr) were determined from single-voxel proton MR spectra measured by PRESS at TE of 80 ms. The results show that the Glu/Cr ratio was reduced in patients with PD compared with controls (t = 2.54; P = 0.019), whereas no differences were observed in NAA/Cr or Cho/Cr ratios. These findings suggest that a reduction in Glu occurs in the cerebral cortex of patients with PD. (1)H MRS at 3 T should be investigated in future studies as a means of tracking the course of metabolic brain changes in association with progression of disease in patients with PD.
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Affiliation(s)
- H Randall Griffith
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
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Griffith HR, den Hollander JA, Stewart CC, Evanochko WT, Buchthal SD, Harrell LE, Zamrini EY, Brockington JC, Marson DC. Elevated brain scyllo-inositol concentrations in patients with Alzheimer's disease. NMR Biomed 2007; 20:709-16. [PMID: 17295394 DOI: 10.1002/nbm.1132] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
in vivo (1)H MRS reveals reduced N-acetylaspartate (NAA) and elevated myo-inositol (mI) in patients with mild Alzheimer's disease (AD) and patients with amnestic mild cognitive impairment (MCI). We are unaware of studies that have documented abnormal scyllo-inositol (sI) levels in patients with AD or patients with MCI, although a previous MRS study in older adults has indicated that sI is a peak of interest to measure in AD. Fifteen patients with mild AD, 26 patients with amnestic MCI, and 19 healthy older adults were recruited to this study. All underwent (1)H MRS of the posterior cingulate gyrus of the brain using a 3 T MRI scanner. Increases in the sI/creatine (Cr) ratio were observed in patients with mild AD (P < 0.05). The mI/Cr ratio was raised in patients with mild AD (P < 0.01) and MCI (P < 0.05). Reduced NAA/Cr was detected in patients with mild AD (P < 0.05). The sI/Cr ratio correlated negatively (r = -0.60, P < 0.05) with a measure of clock drawing in patients with mild AD, indicating that impaired cognitive ability in AD is associated with higher concentrations of sI/Cr. In vivo measurement of sI/Cr in the posterior cingulate gyrus of patients with mild AD revealed increases compared with cognitively healthy older adults. Further research on the mechanisms of sI increase in AD is needed. Future studies on the longitudinal course of sI/Cr in MCI and AD appear warranted.
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Affiliation(s)
- H Randall Griffith
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
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Griffith HR, Hollander JAD, Okonkwo O, Evanochko WT, Harrell LE, Zamrini EY, Brockington JC, Marson DC. Executive function is associated with brain proton magnetic resonance spectroscopy in amnestic mild cognitive impairment. J Clin Exp Neuropsychol 2007; 29:599-609. [PMID: 17691032 DOI: 10.1080/13803390600826595] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Persons with amnestic mild cognitive impairment (MCI) show deficits on executive function measures, although the neuroanatomic basis of executive function in MCI is unknown. We investigated cognitive correlates of 3-tesla proton magnetic resonance spectroscopy (MRS) of the posterior cingulate gyrus in 26 MCI patients. Posterior cingulate ratio of myo-inositol to creatine (mI/Cr) was negatively correlated (-.51) with spontaneous clock drawing. This relationship was not attenuated after accounting for age, overall cognitive function, or memory performance. This finding suggests a role for the posterior cingulate in executive function in MCI. Proton MRS may offer a means to track neurometabolic changes associated with cognitive impairment in MCI.
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Affiliation(s)
- H Randall Griffith
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
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Abstract
A new high-resolution MRSI technique was used to measure extracellular lipids (EMCL), intracellular lipids (IMCL), and total muscle lipids (TML). The purpose of this study was to assess the feasibility and reproducibility of this new technique. This study also compared results obtained from small regions of interest (ROIs) vs. a summation of a large ROI of voxels representing the total soleus or anterior tibialis (TA) muscles. Eight volunteers were studied with the use of a conventional single-slice MR spectroscopic imaging (MRSI) sequence run with the following parameters: TR = 145.9 ms, FOV = 16 cm, slice thickness = 1 cm, and 64 x 64 phase encodes. EMCL, IMCL, and TML values from the small ROIs proved to be reproducible (coefficient of variation (CV) = 7.8-13.8% for soleus, and 8.2-18% for TA). EMCL, IMCL, and TML values from the larger soleus ROI proved to be reproducible (CV = 7.3-16.1%), whereas the larger TA ROIs were less reproducible. The small and larger soleus ROIs produced statistically equivalent measures of EMCL and TML per unit area. However, the small soleus and TA ROIs showed a trend toward yielding different IMCL contents as compared to the larger ROIs. This study demonstrates that high-resolution 1H MRSI of the calf muscle is feasible and can reproducibly measure EMCL, IMCL, and TML.
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Affiliation(s)
- Bradley R Newcomer
- Department of Diagnostic and Therapeutic Sciences, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
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Griffith HR, Okonkwo OC, den Hollander JA, Belue K, Lanza S, Harrell LE, Brockington JC, Clark DG, Marson DC. Brain Proton MRS is Correlated with Financial Abilities in Patients with Alzheimer’s Disease. Brain Imaging Behav 2007. [DOI: 10.1007/s11682-007-9002-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Evanochko WT, Buchthal SD, den Hollander JA, Katholi CR, Bourge RC, Benza RL, Kirklin JK, Pohost GM. Cardiac transplant patients response to the (31)P MRS stress test. J Heart Lung Transplant 2002; 21:522-9. [PMID: 11983541 DOI: 10.1016/s1053-2498(01)00412-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Previous studies showed low resting phosphocreatine/adenosine triphosphate (PCr/ATP) ratios within this patient population compared with controls; however, these low PCr/ATP did not correlate with endomyocardial biopsy rejection. One possible explanation is the presence of cardiac allograft vasculopathy (CAV), which might be manifested as a transient ischemic event in the mildly stressed transplanted heart. If transient ischemia is invoked through the (31)P magnetic resonance spectroscopy (MRS) stress test, monitoring of such an event should be achievable and thus implicating possible ischemic involvement. METHODS Heart transplant patients (n = 25) and normal controls (n = 11) were studied using the (31)P MRS stress test; 10 patients tested positive (> 2 standard deviations [SDs] from control values). Patients also were monitored for heart rate and blood pressure with the handgrip exercise generating a small increase in the rate-pressure product. RESULTS The percent change (%Delta) in the PCr/ATP ratio in the control group was 1.50% +/- 10.6; the transplant population showed an overall change of -6.7% +/- 18.5. The responders, those that were at or below the 2 SD line from control, had a -25.6 +/- 3.6% Delta PCr/ATP; whereas the non-responders reflect a 5.1 +/- 13.4%. The responders' response is quite striking when considering the threshold for an abnormal PCr/ATP %Delta in response to stress testing was -19.7%, which was the 2 SD mark below the mean value for the reference population. DISCUSSION The (31)P MRS stress test showed that a possible transient ischemic event occurred in a subset of patients, thus implicating possible CAV in the cardiac transplant patient. Such an approach may provide an early diagnosis of this disease.
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Affiliation(s)
- William T Evanochko
- Center for NMR Research and Development and the Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
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Buchthal SD, Johnson D, Kim HW, den Hollander JA, Scott KN, Bairey-Merz N, Kelsey SF, Pepine CJ, Pohost GM. Abnormal myocardial phosphorus metabolism in the NIH-NHLBI sponsored Women's Ischemia Syndrome Evaluation (WISE): final phase I results. J Am Coll Cardiol 2002. [DOI: 10.1016/s0735-1097(02)80873-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pohost GM, Buchthal SD, Johnson B, Kim HW, den Hollander JA, Olson MB, Scott KN, Pepine CJ, Mankad S, Kelsey SF, Shaw L, Bairey-Merz N. Abnormal 31P NMR stress test is predictive of myocardial events: a report from the NIH-NHLBI sponsored Women's Ischemia Syndrome Evaluation(WISE). J Am Coll Cardiol 2002. [DOI: 10.1016/s0735-1097(02)82044-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Straeter-Knowlen IM, Butterworth EJ, Buchthal SD, Hollander JAD, Caulfield JB, Jennings RB, Evanochko WT. PCr overshoot': a study of the duration in canine myocardium. NMR Biomed 2002; 15:52-59. [PMID: 11840553 DOI: 10.1002/nbm.757] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The phosphocreatine (PCr) overshoot is a well-documented phenomenon and is readily observable by 31P MRS. In addition, a second 31P MRS observation during ischemia with reperfusion is a diminution in ATP levels. Combining these two as the 'PCr Overshoot' the PCr/ATP ratio may provide an index of viability. However little information is available regarding the duration of this 'overshoot'. For this approach to be useful clinically, the duration of this phenomenon must be ascertained. An open chest canine model of 12 min of ischemia followed by reperfusion (6h) was used. A 2 cm surface coil was sutured to the myocardium and spectra were acquired at 4.7 T. Gated spectra were acquired in <2.5 min with an interpulse delay of 5 s. Integrals of the PCr and ATP (beta) resonances were analyzed using a line-fitting routine. Overall, the PCr signal increased from 22.0+/-0.8 to 25.5+/-0.9 and ATP decreased from 11.7+/-0.4 to 10.0+/-0.4 (arbitrary units). The PCr remained elevated for the entire 6h period and the percentage increase was 15.9%. The ATP remained depleted for the entire 6h period and the percentage decrease was 17.0%. Thus, the clinically relevant and readily observable PCr/ATP is a product of both an increase in PCr and a decrease in ATP for a calculated net increase in PCr/ATP of 39.6%. The PCr/ATP ratio of the ischemia group for baseline, ischemia, 6h reflow, were: 2.33+/-0.18, 1.04+/-0.29 and 3.22+/-0.21. We demonstrate that the 'PCr overshoot' is readily observable and can be monitored noninvasively and nondestructively for 6h. Therefore, the 'PCr overshoot' may be a viable marker of reversible injury in this model and may prove to be applicable for detecting myocardial viability in patients.
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Affiliation(s)
- Ingrid M Straeter-Knowlen
- Department of Medicine, Division of Cardiovascular Disease, Center for Nuclear Imaging Research, University of Alabama at Birmingham, Birmingham, Alabama 35294-4470, USA
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de Roos A, Luyten PR, Mariën AJ, Doornbos J, van der Wall EE, den Hollander JA. Metabolite ratios in normal human myocardium and cardiomyopathy: Quantification by 31p NMR spectroscopy. J Am Coll Cardiol 1991. [DOI: 10.1016/0735-1097(91)91274-i] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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van der Weerdt AJA, Cerfontain H, van der Ploeg JPM, den Hollander JA. Photochemistry of acyclic βγ-unsaturated ketones. Determination of the electronically excited state responsible for α-cleavage by chemically induced dynamic nuclear polarisation. ACTA ACUST UNITED AC 1978. [DOI: 10.1039/p29780000155] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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