Common ~1H-MRS Characteristics in Patients With Alzheimer's Disease and Vascular Dementia Diagnosed With Kidney Essence Deficiency Syndrome: A Preliminary Study

摘要

Context ? Traditional Chinese medicine (TCM) indicates that both Alzheimer's disease (AD) and vascular dementia (VD) should be categorized as dementia and that they have a common etiology and pathogenesis under TCM classification of syndromes, such as with kidney essence deficiency syndrome (KEDS). The pathological location is mainly in the brain. However, it remains unclear whether AD and VD patients with KEDS exhibit a metabolic commonality in the same region of the brain. Objective ? The study intended to investigate the metabolic characteristics of the brain using proton magnetic resonance spectroscopy (~1H-MRS) in patients with AD and VD who had been diagnosed with KEDS. Design ? The research team designed a pilot study, with the participants being allocated to 3 groups: (1) an AD group, (2) a VD group, and (3) a control group. All data analysis was carried out by a trained radiologist who was blinded to each participant's diagnosis. Setting ? The study took place at the Tongde Hospital of Zhejiang Province (Zhejiang Sheng, China). Participants ? Participants were patients at the Tongde Hospital with mild AD or VD who had been diagnosed with KEDS. The normal controls were patients' spouses or guardians with normal cognitive function.Outcome Measures ? All participants underwent ~1H-MRS. The N-acetyl aspartate (NAA)/myo-inositol (mI), NAA/creatine (Cr), choline (Cho)/Cr, and mI/Cr ratios were bilaterally measured in the posterior cingulate gyrus (PCG) and anterior cingulate gyrus (ACG) by the Syngo spectroscopy postprocessing package. Demographic characteristics and ~1H-MRS data were assessed across the AD, VD, and normal control groups. Results ? Thirteen patients with mild AD with KEDS, 15 patients with mild VD with KEDS, and 18 normal controls were recruited from May 2013 through May 2014. The AD and VD groups did not significantly differ in the NAA/mI, NAA/Cr, Cho/Cr, and mI/Cr ratios in either the PCG or the ACG, with the exception being the Cho/Cr ratio in the right ACG, for which the ratio of the AD group was significantly lower when compared with that of the VD group (P< .05).Conclusions ? Mild AD and VD with KEDS showed similar patterns for the ~1H-MRS on the cingulate cortex, providing evidence for a common pathogenesis for the KEDS that is associated with AD and VD, providing a modern biological basis for the philosophy of providing the same treatment for different diseases.