Dementia Japan 31:227-241, 2017

Early diagnosis for Alzheimer's disease using VSRAD combined with magnetic resonance spectroscopy using regular magnetic resonance imaging

Masaaki Waragai¹⁾, Masaru Moriya²⁾

Department of ¹⁾Neurology and ²⁾Radiology, Higashi Matsudo Municipal Hospital

The voxel-based specific regional analysis system for Alzheimer's Disease (VSRAD) using regular magnetic resonance imaging is a widely used tool for early AD diagnosis in Japan.  Proton magnetic resonance spectroscopy (1H MRS) is also used for diagnosis of AD.  The aim of the present study was to validate the utility of VSRAD and 1H MRS for early diagnosis of AD.  We recruited 583 age-matched subjects consisting of normal controls, mild cognitive impairment (MCI), and dementia with Lewy bodies (DLB).
All subjects underwent both VSRAD and 1H MRS in the posterior cingulate gyri, together with measurement of cerebrospinal fluid biomarkers.  Receiver operating characteristic curve analysis showed that VSRAD was highly sensitive and specific for early AD diagnosis, although 8.5% of subjects with MCI/AD showed no brain atrophy on VSRAD.  Although 1H MRS alone was insufficient for AD diagnosis, a decreased n-acetyl aspartate/myo-inositol ratio on 1H MRS was sensitive for neuronal injury preceding to brain atrophy.  Overall, these data suggest that VSRAD combined with 1H MRS can increase the accuracy of early diagnosis of MCI/AD.

Address correspondence to Dr. Masaaki Waragai, Department of Neurology, Higashi Matsudo Municipal Hospital (123-13 Takatsukashinden, Matsudo-shi, Chiba 270-2222, Japan)