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Background:  Investigation on neurochemical changes in the frontal cortex in individuals with Alzheimer’s disease (AD) and different Apolipoprotein E (APOE) genotypes, using  ex vivo  solid-state high-resolution NMR analysis, may lead to a better understanding of the neurochemistry associated with AD as well as new AD-specific metabolite biomarkers that might potentially improve the clinical diagnosis of AD.   Methods:  Intact tissue samples of the frontal cortex were obtained from 11 patients and 11 age-matched non-demented controls. Metabolite profiles in all samples were analyzed  ex vivo , using solid-state high-resolution magic angle spinning (HRMAS) 600 MHz  1 H nuclear magnetic resonance (NMR). A logistic regression analysis was used to rank metabolites based on their level of contribution in differentiating the AD patient tissues and the controls, and different AD-associated APOE genotypes (APOE ε4 vs. APOE ε3).   Results:  Tissue samples from the AD patients showed significantly lower NAA/Cr ( p  = 0.011), Ace/Cr ( p  = 0.027), GABA/Cr ( p  = 0.005), Asp/Cr ( p  < 0.0001), mI/Cr ( p  < 0.0001), and Tau/Cr ( p  = 0.021), and higher PCho/Cr ( p  < 0.0001), GPCho/Cr ( p  < 0.0001), and α&β-Glc/Cr ( p  < 0.0001) than the controls did. Specifically, a newly observed resonance at 3.71 ppm, referred to as α&β-Glc, was observed in 90.9% of the AD samples (10/11). Samples with APOE ε4 also exhibited higher PCho/Cr ( p  = 0.0002), GPCho/Cr ( p  = 0.0001), α&β-Glc/Cr ( p  < 0.0001), and lower Asp/Cr ( p  = 0.004) and GABA/Cr ( p  = 0.04) than the samples with APOE ε3 did. In the logistic regression analysis, PCho, GPCho, ASP, and α&β-Glc were found to be the most relevant metabolites for differentiating the AD patient tissues and the controls, and different APOE genotypes.   Conclusion:  HRMAS  1 H NMR with high spectral resolution and sensitivity offers a powerful tool to gain quantitative information on AD associated neurochemical changes. There are important neurochemical differences in the frontal cortex between the AD patient tissues and the controls, and between those with different APOE genotypes. The resonance (α&β-Glc) found at 3.71 ppm in the AD patient tissues may be further investigated for its potential in the diagnosis and monitoring of AD.

Metabolite Profile of Alzheimer’s Disease in the Frontal Cortex as Analyzed by HRMAS 1H NMR