Proton MR spectroscopy in aging and dementia

Introduction Neuroimaging techniques may have an important role in the clinical evaluation of dementia for early diagnosis, differential diagnosis, and monitoring of disease activity. The goal of this chapter is to review proton MR spectroscopy (MRS) literature in aging and dementia in order to demonstrate the potential clinical applications of the technique. Normal aging Age related changes in proton MRS measurements of the metabolites N-acetyl aspartate (NAA), choline (Cho), creatine (Cr), and myo-inositol (mI) were investigated by several groups, and the results have been conflicting. There are reports showing that metabolite measurements are stable throughout aging;[1] one study showed a decrease in NAA, Cho, and Cr in gray matter,[2] and others an increase in Cho and Cr in the gray matter and white matter with aging.[3-7] As a whole, most studies agree that Cho and Cr increase with aging, and a majority of the studies agree that NAA levels are stable throughout aging (Table 39.1).