Usefulness of medial temporal lobe atrophy visual rating scale in detecting Alzheimer′s disease: Preliminary study

Abstract

Background:The Korean version of Mini-Mental Status Examination (K-MMSE) and the Korean version of Addenbrooke Cognitive Examination (K-ACE) have been validated as quick neuropsychological tests for screening dementia in various clinical settings. Medial temporal atrophy (MTA) is an early pathological characteristic of Alzheimer's disease (AD). We aimed to assess the diagnostic validity of the fusion of the neuropsychological test and visual rating scale (VRS) of MTA in AD.Materials and Methods:A total of fifty subjects (25 AD, 25 controls) were included. The neuropsychological tests used were the K-MMSE and the K-ACE. T1 axial imaging visual rating scale (VRS) was applied for assessing the grade of MTA. We calculated the fusion score with the difference of neuropsychological test and VRS of MTA. The receiver operating characteristics (ROC) curve was used to determine optimal cut-off score, sensitivity and specificity of the fusion scores in screening AD.Results:No significant differences in age, gender and education were found between AD and control group. The values of K-MMSE, K-ACE, CDR, VRS and cognitive function test minus VRS were significantly lower in the AD group than control group. The AUC (Area under the curve), sensitivity and specificity for K-MMSE minus VRS were 0.857, 84% and 80% and for K-ACE minus VRS were 0.884, 80% and 88%, respectively. Those for K-MMSE only were 0.842, 76% and 72% and for K-ACE only were 0.868, 80% and 88%, respectively.Conclusions:The fusion of the neuropsychological test and VRS suggested clinical usefulness in their easy and superiority over neuropsychological test only. However, this study failed to find any difference. This may be because of small numbers in the study or because there is no true difference.

Hippocampal atrophy has limited usefulness as a diagnostic biomarker on the early onset Alzheimer's disease patients: A comparison between visual and quantitative assessment

“…Since its development, Scheltens' HA visual rating scale has been validated in numerous studies as a good predictor of progression from MCI to AD dementia and to discriminate AD from HC and has also been proved to correlate with volumetric methods (Heo et al, 2013; Wahlund et al, 2000). The MTA score has been proposed as the best marker of HA and the MTA ≥ 1.5 cut-off has been recommended to be used for AD diagnosis under the age of 75 (Van de Pol and Scheltens, 2014).…”

“…Most previous studies point to the fact that both visual scales and quantitative analysis are able to discriminate between AD and HC, despite relevant variability in terms of diagnostic performance and they mostly focus on LOAD patients (Heo et al, 2013; Cavedo et al, 2014). In reference to LOAD, our results are in line with previous publications in terms of sensitivity albeit greater specificity in our cohort.…”

“…Is well known that patients in advanced stages of the disease have more HA, thus, in consequence, assessing MTA at these stages could increase its discriminative power; but on the daily clinical practice it is in the early stages of the disease when the differential diagnosis is more complex and it is precisely where biomarkers should be more useful and make the difference. On the other hand, most studies using Scheltens' MTA scale do not have CSF results and the AD diagnosis is based only on clinical criteria (Cuingnet et al, 2011; Heo et al, 2013; Wahlund et al, 2000; Van de Pol and Scheltens, 2014; Duara et al, 2013; Ferreira et al, 2015; Varon et al, 2015; Pereira et al, 2014; Shen et al, 2011; Ridha et al, 2007). We consider this fact to be a significant caveat since trying to establish AD diagnosis without biological confirmation of the disease can lead to higher rates of misdiagnosis (Beach et al, 2012).…”

Corneal nerve and brain imaging in mild cognitive impairment and dementia: A cross-sectional study

“…Duara et al (11) reported that MTA can discriminate probable AD from no cognitive impairment with a good sensitivity (85%) and speci city (82%), above the 80% threshold. (8) Heo et al (9) and Cavedo et al (10) also reported that MTA scoring has high diagnostic accuracy for AD. Our ndings are in line with the study of Falgas et al (36) showing that MTA visual rating can distinguish between AD and healthy controls with 94% speci city but 77% sensitivity using ≥1.5 cut-off or 90% sensitivity with 56% speci city using ≥1 cut-off.…”

Quantitative EEG and medial temporal lobe atrophy in Alzheimer′s dementia: Preliminary study

“…the width of the crural cistern and ambient cistern (C), and the width of the temporal horn of lateral ventricles (D) were assessed and scored from 0 to 4 points. [ 13 14 ]…”