Early diagnostic value of neurotransmitter changes in vulnerable brain regions of patients with subjective cognitive decline detected using proton magnetic resonance spectroscopy

Abstract

This study utilized proton magnetic resonance spectroscopy (1H-MRS) to analyze changes in glutamate-to-creatine ratios (Glu/Cr) in specific brain regions of patients with subjective cognitive decline (SCD) and explored their clinical value for early diagnosis and intervention. Sixty participants, including 30 SCD patients and 30 healthy controls (HCs), were enrolled. Brain imaging was performed using a 3.0T superconducting magnetic resonance scanner. Single-voxel point-resolved spectroscopy sequence (PRESS) was applied for 1H-MRS, focusing on the left posterior cingulate gyrus, hippocampus, and temporal lobe. Glu/Cr ratios were calculated and compared between groups. Correlations between Glu/Cr ratios and cognitive function scores were analyzed. Glu/Cr ratios in the left posterior cingulate gyrus were significantly lower in the SCD group compared to the healthy control group (P = .002), suggesting early metabolic disturbances in this region. However, no significant differences in Glu/Cr ratios were observed in the left hippocampus (P = .312) or temporal lobe (P = .073). Additionally, the Glu/Cr ratio in the posterior cingulate gyrus negatively correlated with cognitive function scores (r = −0.45, P < .001), further emphasizing its potential as a biomarker for early cognitive impairment. This study highlights the diagnostic value of reduced Glu/Cr ratios in the posterior cingulate gyrus for identifying SCD patients at risk of cognitive decline. The findings support the application of 1H-MRS as a noninvasive tool for early detection and monitoring of metabolic changes associated with neurodegenerative processes. Future longitudinal studies are needed to confirm these findings and explore their utility in guiding clinical interventions.