Objective: To study the neuronal integrity of the Anterior (ACC) and Posterior (PCC) Cingulate Cortices with Proton Magnetic Resonance Spectroscopy (H-MRS) across healthy controls (n=17), patients with Lewy Body Dementia (LBD, n=22)), early Parkinson’s Disease (PD, n=18) and patients with idiopathic Rapid Eye Movement Sleep Behaviour Disorder (iRBD, n=23) to further understand the evolution of neurodegenerative disease and to aid diagnosis, treatment and reduce overall burden of disease.

Background: The appreciation of brain biochemistry through the use of H-MRS may offer more sensitive information than structural imaging to detect early pathological changes. Previous studies have suggested that the ACC is associated with the control of executive function, whereas the PCC is more closely linked to impaired memory and dementia. H-MRS has been used to identify neurometabolic changes of neuronal integrity, along with other pathological processes occurring in neurodegenerative diseases.  However, a study comparing the profile of these biological signatures has not been undertaken to date, across synuclein based diseases.

Method: H-MRS data has been collected on 23 iRBD, 18 early PD, 22 DLB and 17 healthy controls. Study participants were recruited from the Brain and Mind Centre PD Research Clinic at the University of Sydney. All participants underwent comprehensive medical, neuropsychological assessment and an MRI scan where H-MRS data was obtained from the ACC as well as the PCC. Data was analysed using LC Model to derive N-acetyl aspartate (NAA, indicator of neuronal integrity), myo-Inositol (ml, a glial marker), and glutathione (GSH, marker of oxidative stress) and was reported as a ratio to creatine (Cr) to facilitate comparison between participants.

Results: We present the patterns of H-MRS across NAA/Cr, mI/Cr and GSH/Cr and initial results indicate that H-MRS may be useful for detecting biomarkers of disease and may in future aid with early diagnosis and monitoring of progression in synuclein patients.

Conclusion: This is the first study to use H-MRS to investigate the relationship between biomarkers of executive function and memory across synucleinopathies compared with controls. This study will have significant implications for early diagnosis of disease in at risk groups and may contribute to the evaluation of disease modifying therapies.

References: 1. Lewis SJG, Shine JM, Duffy SL, Halliday G, Naismith SL. Anterior Cingulate Integrity: Executive and Neuropsychiatric Features in Parkinson’s Disease. Mov Disord 2012; 27(10): 1262-1267 2. Duffy SL, Lagopoulos J, Cross N, LaMonica H, Mowszowski L, Lewis SJG, Hickie IB, Naismith SL. The longitudinal relationship between anterior cingulate glutathione and executive functioning in individuals at risk for dementia: a magnetic resonance spectroscopy study. Alzheimers and Dementia 2017; 13(7): P1383 3. Oz G, Alger JR, Barker PB, Bartha R, et al. Clinical Proton MR Spectroscopy in Central Nervous System Disorders. Radiology 2014; 270(3): 658-679 4. Hu MTM, Taylor-Robinson SD, Chaudhuri KR, Bell JD, et al. Cortical dysfunction in non-demented Parkinson’s disease patients: a combined 31P-MRS and 18FDG-PET study. Brain 2000; 123: 340–352 5. Mangia S, Svatkova A, Mascali D, Nissi MJ, et al. Multi-modal Brain MRI in Subjects with PD and iRBD. Front Neurosci 2017; 11: 709

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MDS Abstracts - https://www.mdsabstracts.org/abstract/utilising-magnetic-resonance-spectroscopy-to-investigate-synucleinopathies/