Journal of Research in Medical Sciences (Jan 2013)
Proton magnetic resonance spectroscopy and cognitive impairment in patients with ischemic white matter lesions
Abstract
Background: The purpose of this study is to investigate the relationship between the cognitive impairment and NAA/Cr and Cho/Cr ratios in the proton magnetic resonance spectroscopy ( 1 HMRS), and to assess the importance of 1 HMRS in the early diagnosis of cognitive impairment in patients with ischemic white matter lesions (WMLs). Materials and Methods: A total of 45 patients (23 males and 22 females) with the ischemic WML were divided into mild WML group (n = 15), moderate WML group (n = 15), and severe WML group (n = 15). A total of 15 healthy controls (8 males and 7 females) with no WML on magnetic resonance imaging were included. 1 HMRS focusing on the frontal lobe white matter around the anterior horn of the lateral ventricle and Montreal Cognitive Assessment (MoCA) were conducted. Results: Patients with more severe WML had lower MoCA scores. The NAA/Cr ratio in 1 HMRS was reduced in all the patients and was strongly correlated with the total MoCA scores (r = 0.845, P < 0.001). The Cho/Cr ratio in 1 HMRS was increased in mild and moderate patients, was negatively correlated with the total MoCA scores (r = 0.907, P < 0.001). The Cho/Cr ratio was reduced in the severe patients and was positively correlated with the total MoCA scores (r = 0.937, P < 0.001). In addition, NAA/Cr and Cho/Cr ratios in 1 HMRS were changed in patients with the mild WML whose total MoCA scores were similar to the controls. Conclusion: Our results suggest that NAA/Cr and Cho/Cr ratios in 1 HMRS are useful indicators for early diagnosis of ischemic WML and cognitive impairment in patients with ischemic WML.
