Regional N-Acetylaspartate Reduction in the Hippocampus Detected With Fast Proton Magnetic Resonance Spectroscopic Imaging in Patients With Alzheimer Disease

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Abstract
PROTON MAGNETIC resonance spectroscopy (1H-MRS) is a noninvasive method to investigate changes of the tissue metabolite composition in different brain diseases. At long echo times (TE >100 milliseconds), the resonance lines of the N-acetyl groups, mainly N-acetylaspartate (NAA), total choline-containing compounds (Cho), and total creatine (tCr), including phosphocreatine and creatine, can be detected. N-acetylaspartate is only located in neurons1 and represents a marker for neuronal integrity. A reduction of NAA has been reported in various brain regions in Alzheimer disease (AD)2 and other neurodegenerative disorders.3-5 Choline-containing compounds represent a constituent of cell membrane metabolism and have been found to be elevated in AD in some6-10 but not all studies.11-18 Total creatine, which is engaged in the cell's energy metabolism, has been reported to remain stable in AD10,19 and other neurodegenerative disorders.20,21 Changes of NAA and Cho are therefore commonly assessed in relation to tCr.