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Altered neurochemical metabolites in Alzheimer's disease patients with unawareness of deficits

  • Yi-Chun Yeh (a1) (a2) (a3), Cheng-Fang Yen (a1) (a2), Chun-Wei Li (a4), Yu-Ting Kuo (a4) (a5) (a6) (a7), Chia-Hui Chen (a8), Chen-Chang Lee (a9), Gin-Chung Liu (a4) (a5) (a7), Mei-Feng Huang (a1) (a3), Tai-Ling Liu (a1) (a3) and Cheng-Sheng Chen (a1) (a2)...



Unawareness of deficits is common and is associated with poor outcomes in Alzheimer's disease (AD); however, little is known about correlated neurobiochemical changes.


Proton magnetic resonance spectroscopy was used to examine neurobiochemical correlates of unawareness of deficits as assessed by the Dementia Deficit Scale in 36 patients with AD. Magnetic resonance spectroscopy spectra were acquired from the anterior cingulate area and right orbitofrontal area. Concentrations of N-acetyl-aspartate (NAA), total creatine, and other neurometabolites were calculated.


Nineteen (52.8%) participants had relative unawareness of deficits. This condition was negatively correlated with NAA/creatine in the anterior cingulate area (β = −0.36, p = 0.025) and positively correlated with NAA/creatine in the right orbitofrontal area (β = 0.41, p = 0.009) after controlling for dementia severity.


These findings suggest unawareness of deficits in AD was associated with the altered neurochemical metabolites in the anterior cingulate area and right orbitofrontal area. However, the two areas might have opposite neuronal functions in unawareness of deficits.


Corresponding author

Correspondence should be addressed to: Cheng-Sheng Chen and Cheng-Feng Yen, Department of Psychiatry, Kaohsiung Medical University Hospital, #100, Tzyou 1st Rd, Kaohsiung City, Taiwan 807. Phone: +886-7-312-1101, ext. 6816; Fax: +886-7-3134761. Email: or


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