{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T09:39:27Z","timestamp":1789983567630,"version":"4.0.1"},"reference-count":61,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2010,12,3]]},"published-print":{"date-parts":[[2011]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mild cognitive impairment (MCI) of an amnestic type is a common condition in older people and highly predictive of Alzheimer's disease (AD). To date, there is no clear consensus regarding the best antecedent biomarker to predict early conversion to AD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      The aim of the study is to demonstrate that\n                      <jats:sup>1<\/jats:sup>\n                      H magnetic resonance spectroscopy (MRS) of the brain in MCI patients may predict early conversion to dementia within the 2-year period after baseline assessment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cohort of patients fulfilling the criteria of amnestic MCI were enrolled consecutively. At baseline the patients underwent neuropsychological examination, standard blood tests and APOE genotype.\n                      <jats:sup>1<\/jats:sup>\n                      H-MRS (1.5 T) of the brain was carried out by exploring two areas: the posteromedial bilateral parietal lobe and left medial occipital lobe. The patients were followed up to detect conversion to probable AD according to the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association group criteria.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After a 2-year follow-up, 27 (38%) patients converted to AD. The mean N-acetyl-aspartate\/creatine (NAA\/Cr) ratio in the posteromedial bilateral parietal cortex was 1.38 in converters versus 1.49 in non-converters (p&lt;0.0001). An NAA\/Cr ratio equal to or lower than 1.43 in this area predicted conversion to probable AD at 74.1% sensitivity and 83.7% specificity (area under the curve: 0.84; 95% CI 0.73 to 0.92). The cross-validated accuracy of classification was 82%, which reaches 85% when the APOE4 genotype and memory test are included in the analysis. In the left medial occipital lobe, the predictive value was somewhat lower with 85.2% sensitivity and 61.4% specificity (area under the curve: 0.8; 95% CI 0.69 to 0.89). Neither the APOE4 genotype nor leuco-araiosis was predictive of conversion to dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MRS is a valuable biomarker to predict early conversion to dementia in patients with amnestic MCI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2010-000007","type":"journal-article","created":{"date-parts":[[2011,3,24]],"date-time":"2011-03-24T20:58:03Z","timestamp":1301000283000},"page":"e000007","source":"Crossref","is-referenced-by-count":49,"title":["Magnetic resonance spectroscopy in the prediction of early conversion from amnestic mild cognitive impairment to dementia: a prospective cohort study"],"prefix":"10.1136","volume":"1","author":[{"given":"Pedro J","family":"Modrego","sequence":"first","affiliation":[{"name":"Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Fayed","sequence":"additional","affiliation":[{"name":"Department of Radiology, Clinica Quiron, Zaragoza, Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Sarasa","sequence":"additional","affiliation":[{"name":"Laboratory of Neurobiology, University of Zaragoza, Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2011,2,23]]},"reference":[{"key":"2025120521371582000_1.1.e000007.1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.56.3.303"},{"key":"2025120521371582000_1.1.e000007.2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.58.3.397"},{"key":"2025120521371582000_1.1.e000007.3","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000034176.07159.F8"},{"key":"2025120521371582000_1.1.e000007.4","doi-asserted-by":"crossref","unstructured":"Birks J Flicker L . Donepezil for mild cognitive impairment. Cochrane Database Syst Rev 2006;(3):CD006104.","DOI":"10.1002\/14651858.CD006104"},{"key":"2025120521371582000_1.1.e000007.5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040338"},{"key":"2025120521371582000_1.1.e000007.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0149-2918(02)80004-2"},{"key":"2025120521371582000_1.1.e000007.7","first-page":"897","article-title":"The radiologic prediction of Alzheimer's disease: the atrophic hippocampal formation","volume":"14","author":"De Le\u00f3n","year":"1993","journal-title":"Am J Neuroradiol"},{"key":"2025120521371582000_1.1.e000007.8","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.7.1397"},{"key":"2025120521371582000_1.1.e000007.9","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8249(200004)47:4<430::AID-ANA5>3.0.CO;2-I"},{"key":"2025120521371582000_1.1.e000007.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0197-4580(01)00271-8"},{"key":"2025120521371582000_1.1.e000007.11","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.72.4.491"},{"key":"2025120521371582000_1.1.e000007.12","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000133114.92694.93"},{"key":"2025120521371582000_1.1.e000007.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurobiolaging.2003.12.007"},{"key":"2025120521371582000_1.1.e000007.14","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000180958.22678.91"},{"key":"2025120521371582000_1.1.e000007.15","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000160089.43264.1A"},{"key":"2025120521371582000_1.1.e000007.16","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000256697.20968.d7"},{"key":"2025120521371582000_1.1.e000007.17","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.59.11.1729"},{"key":"2025120521371582000_1.1.e000007.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2003.08.011"},{"key":"2025120521371582000_1.1.e000007.19","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1034\/j.1600-0404.107.s179.9.x","article-title":"Cerebrospinal fluid levels of total-tau, phospho-tau and A Beta42 predicts development of Alzheimer's disease in patients with mild cognitive impairment","volume":"179","author":"Andreasen","year":"2003","journal-title":"Acta Neurol Scand"},{"key":"2025120521371582000_1.1.e000007.20","doi-asserted-by":"publisher","DOI":"10.1038\/sj.mp.4001473"},{"key":"2025120521371582000_1.1.e000007.21","doi-asserted-by":"publisher","DOI":"10.1080\/13554790490896901"},{"key":"2025120521371582000_1.1.e000007.22","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3940(02)01038-8"},{"key":"2025120521371582000_1.1.e000007.23","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2005.051201"},{"key":"2025120521371582000_1.1.e000007.24","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1064"},{"key":"2025120521371582000_1.1.e000007.25","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.159.5.738"},{"key":"2025120521371582000_1.1.e000007.26","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa054625"},{"key":"2025120521371582000_1.1.e000007.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.pscychresns.2006.12.003"},{"key":"2025120521371582000_1.1.e000007.28","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.191044198"},{"key":"2025120521371582000_1.1.e000007.29","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000147469.18313.3B"},{"key":"2025120521371582000_1.1.e000007.30","first-page":"1625","article-title":"Prediction of individual clinical outcome in MCI by means of genetic assessment and (18)F-FDG PET","volume":"46","author":"Drzezga","year":"2005","journal-title":"J Nucl Med"},{"key":"2025120521371582000_1.1.e000007.31","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.62.11.1728"},{"key":"2025120521371582000_1.1.e000007.32","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1212\/01.WNL.0000141849.21256.AC","article-title":"1H MR spectroscopy in common dementias","volume":"63","author":"Kantarci","year":"2004","journal-title":"Neurology"},{"key":"2025120521371582000_1.1.e000007.33","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.2.210"},{"key":"2025120521371582000_1.1.e000007.34","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.20419"},{"key":"2025120521371582000_1.1.e000007.35","doi-asserted-by":"publisher","DOI":"10.1159\/000066021"},{"key":"2025120521371582000_1.1.e000007.36","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.187.2.8475286"},{"key":"2025120521371582000_1.1.e000007.37","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.195.1.7892497"},{"key":"2025120521371582000_1.1.e000007.38","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)03759-3"},{"key":"2025120521371582000_1.1.e000007.39","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.4.667"},{"key":"2025120521371582000_1.1.e000007.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2008.04.008"},{"key":"2025120521371582000_1.1.e000007.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurobiolaging.2005.05.002"},{"key":"2025120521371582000_1.1.e000007.42","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181a2e864"},{"key":"2025120521371582000_1.1.e000007.43","doi-asserted-by":"publisher","DOI":"10.1016\/j.pscychresns.2008.07.015"},{"key":"2025120521371582000_1.1.e000007.44","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1212\/WNL.52.2.231","article-title":"Screening for dementia with the memory impairment screen","volume":"52","author":"Buschke","year":"1999","journal-title":"Neurology"},{"key":"2025120521371582000_1.1.e000007.45","first-page":"189","volume":"7","author":"Lobo","year":"1979","journal-title":"Actas Luso Esp Neurol Psiquiatr Cienc Afines"},{"key":"2025120521371582000_1.1.e000007.46","doi-asserted-by":"publisher","DOI":"10.1179\/174313209X395481"},{"key":"2025120521371582000_1.1.e000007.47","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2009.02816.x"},{"key":"2025120521371582000_1.1.e000007.48","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.34.7.939"},{"key":"2025120521371582000_1.1.e000007.49","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.42.8.1578"},{"key":"2025120521371582000_1.1.e000007.50","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2481071590"},{"key":"2025120521371582000_1.1.e000007.51","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000201237.05869.df"},{"key":"2025120521371582000_1.1.e000007.52","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181f073c7"},{"key":"2025120521371582000_1.1.e000007.53","doi-asserted-by":"publisher","DOI":"10.1159\/000088558"},{"key":"2025120521371582000_1.1.e000007.54","doi-asserted-by":"publisher","DOI":"10.1097\/00005072-200606000-00010"},{"key":"2025120521371582000_1.1.e000007.55","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181e8e8b8"},{"key":"2025120521371582000_1.1.e000007.56","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181b23564"},{"key":"2025120521371582000_1.1.e000007.57","doi-asserted-by":"publisher","DOI":"10.2174\/156720506776383103"},{"key":"2025120521371582000_1.1.e000007.58","doi-asserted-by":"publisher","DOI":"10.3844\/ajassp.2006.1836.1845"},{"key":"2025120521371582000_1.1.e000007.59","doi-asserted-by":"publisher","DOI":"10.1080\/02841850802709219"},{"key":"2025120521371582000_1.1.e000007.60","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.pscychresns.2008.04.002","article-title":"Single voxel MR spectroscopy at 3T in a memory disorders clinic: early right hippocampal NAA\/Cr loss in mildly impaired subjects","volume":"164","author":"Caserta","year":"2008","journal-title":"Psychiatry Res"},{"key":"2025120521371582000_1.1.e000007.61","doi-asserted-by":"crossref","unstructured":"Danielsen ER Ross B . Basic physics of MRS. In: Danielsen ER Ross B , eds. Magnetic Resonance Spectroscopy Diagnosis of Neurological Diseases. New York: Marcel Dekker, 1999:5\u201322.","DOI":"10.4324\/9780429177200-2"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2010-000007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T05:37:22Z","timestamp":1764999442000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2010-000007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011]]},"references-count":61,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2011,9,2]]},"published-print":{"date-parts":[[2011]]}},"alternative-id":["10.1136\/bmjopen-2010-000007"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2010-000007","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011]]}}}