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Resumen: Objective To assess the accuracy of magnetic resonance spectroscopy (1H-MRS) and brain volumetry in mild cognitive impairment (MCI) to predict conversion to probable Alzheimer''s disease (AD). Methods Forty-eight patients fulfilling the criteria of amnestic MCI who underwent a conventional magnetic resonance imaging (MRI) followed by MRS, and T1-3D on 1.5 Tesla MR unit. At baseline the patients underwent neuropsychological examination. 1H-MRS of the brain was carried out by exploring the left medial occipital lobe and ventral posterior cingulated cortex (vPCC) using the LCModel software. A high resolution T1-3D sequence was acquired to carry out the volumetric measurement. A cortical and subcortical parcellation strategy was used to obtain the volumes of each area within the brain. The patients were followed up to detect conversion to probable AD. Results After a 3-year follow-up, 15 (31.2%) patients converted to AD. The myo-inositol in the occipital cortex and glutamate + glutamine (Glx) in the posterior cingulate cortex predicted conversion to probable AD at 46.1% sensitivity and 90.6% specificity. The positive predictive value was 66.7%, and the negative predictive value was 80.6%, with an overall cross-validated classification accuracy of 77.8%. The volume of the third ventricle, the total white matter and entorhinal cortex predict conversion to probable AD at 46.7% sensitivity and 90.9% specificity. The positive predictive value was 70%, and the negative predictive value was 78.9%, with an overall cross-validated classification accuracy of 77.1%. Combining volumetric measures in addition to the MRS measures the prediction to probable AD has a 38.5% sensitivity and 87.5% specificity, with a positive predictive value of 55.6%, a negative predictive value of 77.8% and an overall accuracy of 73.3%. Conclusion Either MRS or brain volumetric measures are markers separately of cognitive decline and may serve as a noninvasive tool to monitor cognitive changes and progression to dementia in patients with amnestic MCI, but the results do not support the routine use in the clinical settings.
Idioma: Inglés
DOI: 10.1016/j.mri.2016.12.010
Año: 2017
Publicado en: MAGNETIC RESONANCE IMAGING 38 (2017), 27-32 [27 p.]
ISSN: 0730-725X
Factor impacto JCR: 2.564 (2017)
Categ. JCR: RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING rank: 45 / 127 = 0.354 (2017) - Q2 - T2
Factor impacto SCIMAGO: 1.063 - Biomedical Engineering (Q1) - Radiology, Nuclear Medicine and Imaging (Q1) - Biophysics (Q1)

Tipo y forma: Article (PostPrint)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)

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