Proton Magnetic Resonance Spectroscopy Reveals Similar White Matter Biochemical Changes in Patients with Chronic Hypertension and Early Alzheimer's Disease

Catani, Marco; Mecocci, Patrizia; Tarducci, R.; Howard, Robert; Pelliccioli, G.P.; Mariani, Elisabetta; Metastasio, Antonio; Benedetti, Claudia; Senin, Umberto; Cherubini, Antonio

doi:10.1046/j.1532-5415.2002.50465.x

Cited by 33 publications

(24 citation statements)

References 18 publications

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“…The increase in PPL mI/Cr in our series agrees with a previous report showing higher mI/Cr values in the peritrigonal white matter of patients with asymptomatic hypertension. 5 Regarding the changes in frontal NAA/Cr ratio, the ratio drop in our resistant hypertensive patients is in agreement with two recent chemical-shift imaging reports involving the white matter of the centrum semiovale 21 and particular areas in the white and gray matters. 22 These studies showed decreasing NAA concentrations associated with increasing severity of disease 21 and NAA/Cr decreases in the gray matter of hypertensive patients.…”

Section: Discussionsupporting

confidence: 92%

“…In addition, the originality of these results also dwells in the sample characteristics. Although, in the other quoted papers, comparisons were carried out between groups of normal vs asymptomatic hypertensive patients, 5,22 symptomatic vs asymptomatic hypertensive patients, 21 or treated vs untreated patients, 23 we focused on the effect of medical treatment by comparing two groups of treated asymptomatic hypertensive patients with opposing outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Increases in MRS myoinositol (mI)/creatine (Cr) ratio have been reported in pre-dementia and in the very early stages of Alzheimer's disease, 4 as well as in asymptomatic hypertension. 5 We took into account the mean and s.d. (0.56 ± 0.04) of the control group ratio reported in this paper 5 and a mI/Cr s. d. measurement of 0.036 found after a pilot random assessment involving 15 hypertensive patients from our sample.…”

Section: Sample Size Calculationmentioning

confidence: 99%

“…5 We took into account the mean and s.d. (0.56 ± 0.04) of the control group ratio reported in this paper 5 and a mI/Cr s. d. measurement of 0.036 found after a pilot random assessment involving 15 hypertensive patients from our sample. Assuming 5 and 20% a and b errors, respectively, 14 control subjects and 35 hypertensive patients were estimated to be adequate to obtain a 0.036 deviation difference between normotensive and hypertensive subjects.…”

Section: Sample Size Calculationmentioning

confidence: 99%

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Posterior paralimbic and frontal metabolite impairments in asymptomatic hypertension with different treatment outcomes

et al. 2009

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Hypertension is associated with cognitive decline in elderly persons. We studied asymptomatic hypertensive subjects using brain magnetic resonance (MR) spectroscopy to evaluate metabolite impairments before the appearance of symptoms in patients with different treatment outcomes. In all, 14 healthy controls and 37 asymptomatic hypertensive patients (17 controlled and 20 resistant) underwent brain structural MR and MR spectroscopy of the posterior paralimbic (PPL) area and left frontal white matter. Ischemic burden (IB), global cortical atrophy and microbleeds were analyzed with visual scales. Metabolite ratios involving N-acetyl-aspartate (NAA), creatine (Cr), choline (Cho) and myoinositol (mI) were computed. Ultrasound measurements, including intima-media thickness, plaques and hemodynamic ratios, were obtained. Intergroup differences in IB, atrophy and metabolite ratios, and the atrophy and IB relationship were assessed with parametric and nonparametric statistical tests. In addition, the impacts of demographic, analytic and clinical factors, ischemia and atrophy, and ultrasound measurements on metabolite ratios were assessed. The significance level was set at Pp0.05. Higher atrophy scores presented with higher total or frontal IB (Po0.05). However, there was no intergroup difference in atrophy and IB. PPL mI/Cr was increased in resistant hypertension (Po0.021), whereas frontal NAA/Cr (Po0.007) showed opposite trends between controlled (increased ratios) and resistant (decreased ratios) hypertension. Unlike PPL mI/Cr, frontal NAA/Cr showed significant correlations with the lipid profile and ultrasound measurements. PPL mI/Cr increases in resistant hypertension, and frontal NAA/Cr diverges between controlled and resistant hypertension before physical and neuropsychological symptoms appear.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Sample Size Calculationmentioning

confidence: 99%

Section: Sample Size Calculationmentioning

confidence: 99%

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Posterior paralimbic and frontal metabolite impairments in asymptomatic hypertension with different treatment outcomes

et al. 2009

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“…It is involved in several important cellular processes in the brain as a marker of phospholipid turnover and gliosis, a secondary messenger and a detoxifying molecule (Catani et al, 2002;LopezVillegas et al, 1997;Shonk et al, 1995). In addition to depression, mI has been observed as elevated in patients with Alzheimer's disease, mild cognitive impairment (Huang et al, 1999;Kantarci et al, 2000;, primary progressive aphasia (Catani et al, 2003), and hypertension (Catani et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Brain Metabolites and Cognitive Function among Older Depressed and Healthy Individuals Using 2D MR Spectroscopy

Elderkin‐Thompson

Thomas

Binesh

et al. 2004

Neuropsychopharmacol

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Brain metabolites of choline (Ch) and myo-Inisotol (mI) have been reported as elevated among geriatric depressed patients. Twodimensional (2D) magnetic resonance spectroscopy (MRS) provides estimates of Ch, mI, and creatine (Cr) similar to one-dimensional MRS, and it also estimates the resonances of the Ch-containing compounds of phosphoethanolamine (Pe) and phosphocholine (PCh). In this cross-sectional geriatric study, 14 depressed patients and 14 healthy volunteers who were comparable in age, gender, education, comorbid medical burden, and Mini-Mental State Examination (MMSE) scores completed 2D MRS and a neurocognitive battery. A voxel in the left dorsolateral cortex, which was comprised of approximately 60% white matter, was used to estimate the CR ratios of Ch, PCh, Pe, and mI. Composite scores for cognitive function were developed for verbal learning, recall, recognition, executive function, hypothesis generation, and processing speed. Among nondepressed subjects, cognition was positively correlated with Ch/Cr and mI/Cr and negatively correlated with PCh/Cr in four domains of verbal learning, recognition, recall, and hypothesis generation. In contrast, depressed patients did not have consistent relationships between Ch/Cr, mI/Cr, and PCh/Cr and cognition. There was a significant difference in the overall pattern of associations between the four metabolites and verbal learning and processing speed in depressed patients compared to healthy controls. The attenuated relationship between metabolites and specific cognitive domains in patients with late-life MDD suggests that the level of cognitive performance observed during depressive episodes may be associated with changes in biochemistry within the frontostriatal neuronal circuitry.

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Axonal injury within language network in primary progressive aphasia

Catani

Piccirilli

Cherubini

et al. 2002

Annals of Neurology

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Primary progressive aphasia (PPA) is characterized by an isolated progressive impairment of word use and comprehension reflecting the distribution of pathological processes within the left hemisphere. We used proton magnetic resonance spectroscopy (1H-MRS) to study in vivo the integrity of axonal fibers connecting perisylvian language areas in 11 patients with PPA, 11 subjects with Alzheimer's disease, and 22 controls. Brain metabolites (N-acetylaspartate, myoinositol, choline, creatine) were measured bilaterally within a volume of interest located in the central portion of the superior longitudinal fasciculus, a long associative bundle connecting Broca's area with Wernicke's area, and other language regions of the temporal lobe. In the PPA group, there was an asymmetrical N-acetylaspartate to creatine ratio reduction compared with Alzheimer's disease and controls, with greater changes on the left side. The myoinositol to creatine ratio was increased in the PPA group bilaterally compared with controls. The choline to creatine ratio did not differ among the three groups. These results indicate an asymmetrical focal axonal injury within the language network in PPA. The marked difference in the distribution of N-acetylaspartate to creatine between PPA and Alzheimer's disease suggests that proton magnetic resonance spectroscopy may help to differentiate between these two conditions.

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Proton Magnetic Resonance Spectroscopy Reveals Similar White Matter Biochemical Changes in Patients with Chronic Hypertension and Early Alzheimer's Disease

Cited by 33 publications

References 18 publications

Posterior paralimbic and frontal metabolite impairments in asymptomatic hypertension with different treatment outcomes

Posterior paralimbic and frontal metabolite impairments in asymptomatic hypertension with different treatment outcomes

Brain Metabolites and Cognitive Function among Older Depressed and Healthy Individuals Using 2D MR Spectroscopy

Axonal injury within language network in primary progressive aphasia

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