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¹H Magnetic resonance spectroscopy in dementia

Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA

Correspondence: Kejal Kantarci, MD, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. E-mail: kantarci.kejal{at}mayo.edu

Present data support the concept that ¹H magnetic resonance spectroscopy (¹H MRS) may become an adjunct to clinical evaluation for differential diagnosis of dementia in the future. The value of ¹H MRS in monitoring the disease progression in dementia is expected to be in areas where group effects are sought such as monitoring effectiveness of therapies in drug trials. Elevation of myoinositol to creatine (mI/Cr) and choline to creatine (Cho/Cr) and reduction in the neuronal integrity marker N-acetylaspartate to creatine (NAA/Cr) levels in individuals with mild cognitive impairment and pre-symptomatic Alzheimer's disease suggests that ¹H MRS may also be valuable in predicting future development of dementia and monitoring early disease progression for preventive therapies. Investigations of in vivo ¹H MRS as a marker for differential diagnosis and progression of dementia, however, has been limited to clinically confirmed cohorts and remains to be validated by histopathology at autopsy. Overall, MRS is a promising investigational technique in ageing and dementia at this time. The potential clinical application of MRS in ageing and dementia, however, is growing with technical advances in the field.