Abstract
Objective To have a systemic review of the association between relative ratio in proton magnetic resonance spectroscopy (1H-MRS) and Alzheimer's disease (AD). Methods A search in Medline and China National Knowledge Infrastructure (CNKI) was performed,and relevant English and Chinese-language articles about assessing AD with 1 H-MRS were identifed.The data of relative metabolic ratios (NAA/Cr,Cho/Cr,mI/Cr ) from different brain regions (hippocampus,posterior cingulate gyrus,temporal lobe,parietal lobe,frontal lobe,occipital lobe) were extracted from the articles.The quality of the articles was evaluated according to the standard recommended by Newcastle-Ottawa criteria. The Meta-analysis was done with the Review Manager 4.2 to calculate pooled weighted mean difference (WMD) with 95％ confidence interval (95％ CI ),and linear correlation analysis between NAA/Cr ratio and mI/Cr ratio was done by SPSS 17.0.Results Thirty six articles (27 English articles,9 Chinese articles) were included. After heterogeneity test was done,fixed effects model or random effects model was selected. The meta-analysis showed that the NAA/Cr ratio in patients with AD was higher than that in controls ( WMD:-0.14,95％CI:-0.17 to -0.11 ).The mI/Cr ratio in patients with AD was lower than that in controls ( WMD:0.10,95％ CI:0.07 to 0.13 ).There were greatest changes in NAA/Cr ratio and mI/Cr ratio on the hippocampus ( WMD of NAA/Cr: - 0.27,95％ CI:- 0.36 to - 0.19 ; WMD of mI/Cr:0.21,95％ CI:0.10 to 0.33). There were also no differences between patients with AD and controls with respect to the Cho/Cr ratio (WMD:0.01,95％ CI:0.00 to 0.01,P ＞0.05). The NAA/Cr and mI/Cr changes are markedly correlated with each other in different brain regions ( r =0.947,P =0.004). Conclusion The hippocampus region is the first to present neuropathological changes in AD and the changes of NAA/Cr and MI/Cr might reflect the neurodegenerative process of AD. Key words: Alzheimer disease ; Magnetic resonance spectroscopy ; Meta analysis
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