alexa Volumetric and Visual Rating of MRI scans in the Diagnosis of Amnestic MCI and Alzheimer's Disease


Journal of Aging Science

Author(s): Qian Shen, David A Loewenstein, Elizabeth Potter, Weizhao Zhao, Jason Appel

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Background In the diagnosis of Alzheimer's disease, structural MRI scans have been used primarily to exclude non-Alzheimer's cause of dementia. However, the pattern and extent of medial temporal atrophy (MTA) on structural MRI scans, which correlates strongly with the pathological severity of Alzheimer's disease (AD), can be used to support the diagnosis of a degenerative dementia, especially AD, even in its early pre-dementia stage. Methods Elderly subjects (n = 224) were diagnosed to have no cognitive impairment (NCI), amnestic mild cognitive impairment (aMCI), or AD. Hippocampal and hemispheric gray matter volumes were measured on structural MRI scans, and a new visual rating system (VRS) was used to score the severity of MTA (VRS-MTA) of the hippocampus (HPC), entorhinal cortex (ERC) and perirhinal cortex (PRC) on a coronal image intersecting the mammillary bodies. Results Although both VRS-MTA scores and HPC volumes distinguished between NCI, aMCI and AD subjects, aMCI and NCI subjects could be better distinguished using right VRS-MTA scores, in comparison to right HPC volumes. VRS-MTA scores were more highly correlated with episodic memory and Clinical Dementia Rating scores. A combination of left side VRS-MTA scores and left side hippocampal volume was the most predictive measure of diagnostic classification. Conclusion VRS-MTA is a clinically convenient method of distinguishing aMCI or AD from NCI. Compared with volumetric measures, it provides better discriminatory power and correlates more strongly with memory and functional scores.

This article was published in Alzheimers Dement. and referenced in Journal of Aging Science

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