Magnetic Resonance Spectroscopy in Alzheimer's Disease: Systematic Review and Meta-Analysis

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#alzheimer-disease #aspartic-acid #brain #creatine #databases-bibliographic

Magnetic Resonance Spectroscopy in Alzheimer's Disease: Systematic Review and Meta-Analysis

Wang et al., 2015 | J Alzheimers Dis | Meta Analysis

Citation

Wang Hui, Tan Lan, ... Yu Jin-Tai. Magnetic Resonance Spectroscopy in Alzheimer's Disease: Systematic Review and Meta-Analysis. J Alzheimers Dis. 2015;46(4):1049-70. doi:10.3233/JAD-143225

Abstract

BACKGROUND: The application of non-invasive proton magnetic resonance spectroscopy (1H-MRS) could potentially identify changes in cerebral metabolites in the patients with Alzheimer's disease (AD). However, whether these metabolites can serve as biomarkers for the diagnosis of AD remains unclear. OBJECTIVE: Using meta-analysis, we aimed to investigate the patterns of cerebral metabolite changes in several cerebral regions that are strongly associated with cognitive decline in AD patients. METHODS: Using Hedges' g effect size, a systematic search was performed in PubMed, Cochrane Library, Ovid, Embase, and EBSCO, and 38 studies were integrated into the final meta-analysis. RESULTS: According to the observational studies, N-acetyl aspartate (NAA) in AD patients was significantly reduced in the posterior cingulate (PC) (effect size (ES) =-0.924, p <  0.005) and bilateral hippocampus (left hippocampus: ES =-1.329, p <  0.005; right hippocampus: ES =-1.287, p <  0.005). NAA/Cr (creatine) ratio decreased markedly in the PC (ES =-1.052, p <  0.005). Simultaneously, significant elevated myo-inositol (mI)/Cr ratio was found not only in the PC but also in the parietal gray matter. For lack of sufficient data, we failed to elucidate the efficacy of pharmacological interventions with the metabolites changes. CONCLUSION: The available data indicates that NAA, mI, and the NAA/Cr ratio might be potential biomarkers of brain dysfunction in AD subjects. Choline (Cho)/Cr and mI/NAA changes might also contribute toward the diagnostic process. Thus, large, well-designed studies correlated with cerebral metabolism are needed to better estimate the cerebral extent of alterations in brain metabolite levels in AD patients.

Key Findings

According to the observational studies, N-acetyl aspartate (NAA) in AD patients was significantly reduced in the posterior cingulate (PC) (effect size (ES) =-0.924, p <  0.005) and bilateral hippocampus (left hippocampus: ES =-1.329, p <  0.005; right hippocampus: ES =-1.287, p <  0.005). NAA/Cr (creatine) ratio decreased markedly in the PC (ES =-1.052, p <  0.005). Simultaneously, significant elevated myo-inositol (mI)/Cr ratio was found not only in the PC but also in the parietal gray matter.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population alzheimer
Sample Size 38
Age Range See abstract
Condition cognitive

MeSH Terms

  • Alzheimer Disease
  • Aspartic Acid
  • Brain
  • Creatine
  • Databases, Bibliographic
  • Humans
  • Magnetic Resonance Imaging
  • Magnetic Resonance Spectroscopy
  • Protons

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review
  • Vertical: creatine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09