Characteristic early changes of Glu and Cho in brain regions affected by different types of subjective cognitive decline and their clinical significance

Abstract

To discuss the early changes of Glu and Cho in the affected areas of different types of subjective cognitive decline, including amnestic MCI (aMCl), non-amnestic MCI (naMCI) and vascular cognitive impairment no dementia (VCIND), using Proton Magnetic Resonance Spectroscopy (1H-MRS) technology. Routine head MRI and lH-MRS examinations were performed on 50 clearly diagnosed aMCI patients, 44 naMCI patients, 44 VCIND patients, and 44 elderly individuals with normal cognitive function. Measure the volume of the patient bilateral hippocampus. Using the bilateral hippocampus, left posterior cingulate gyrus (PCG), and frontal lobe as regions of interest, the scope under the peak of N-acetylaspartate (NAA), choline complex (Cho), glutamate (Glu), Metabolic Images (mI), and creatine (Cr) was tested. Perform a correlation analysis between the NAA/Cho/Cr values of the VCIND group and the MoCA score. All experimental subjects were right-handed. The NAACr values in both hippocampus of the VCIND were greatly lower than those in control (P < .05). The NAA/Cr values on both sides of the VCIND were correlated with the MoCA score (P < .05). The NAA/Cr values in the LHp and PCG of subjects in the aMCI and naMCI groups were lower than those in the NC group (P < .05). The NAA/Cr values in the left frontal lobe of the aMCI and naMCI showed no obvious decrease compared to the NC. The Glu/Cr of subjects in the aMCI was lower in the left PCG than those in the naMCI and NC (P < .05). The discrepancy between the naMCI and the NC was P > .05. In the LHp and frontal lobe, in contrast with the naMCI and NC, the mI/Cr values in the LHp and PCG of subjects in the aMCI were higher (P < .05). In the left frontal lobe, relative to the aMCI and NC, the mI/Cr values in the naMCI were higher (P < .05). The changes in the concentration of 1H-MRS metabolites in the hippocampus can indicate the presence of hippocampal neuronal damage before morphological changes occur in the hippocampus. 1H-MRS NAA/Cr can reflect the cognitive function changes of patients to a certain extent. There are regional differences in mI and Glu metabolism in the brain between aMCI and naMCI groups. 1H-MRS provides an effective basis for clinical differentiation between aMCI and naMCI.

Figure 1.

¹H-MRS detection results of bilateral hippocampus in patients with VCIND group. VCIND = vascular cognitive impairment no dementia.

Figure 2.

¹H-MRS detection results of LHp in VCIND group patients and NC group patients. VCIND = vascular cognitive impairment no dementia.

Figure 3.

Correlation analysis results between NAA/Cr, Cho/Cr, and MoCA scores in the LHp of patients in the VCIND group. VCIND = vascular cognitive impairment no dementia.

Figure 4.

Correlation analysis between Cho/Cr values, NAA/Cr values, and MoCA scores in the RHp of patients in the VCIND group. VCIND = vascular cognitive impairment no dementia.