Visual Evaluation of Medial Temporal Lobe Atrophy as a Clinical Marker of Conversion from Mild Cognitive Impairment to Dementia and for Predicting Progression in Patients with Mild Cognitive Impairment and Mild Alzheimer's Disease

Persson, Karin; Barca, Maria Lage; Eldholm, Rannveig Sakshaug; Cavallin, Lena; Benth, Jūratė Šaltytė; Selbæk, Geir; Brækhus, Anne; Saltvedt, Ingvild; Engedal, Knut

doi:10.1159/000477342

Cited by 13 publications

(10 citation statements)

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“…The patients were recruited from a larger study for which the inclusion process has been described thoroughly in a previous paper [ 14 ]. For the present study, only patients with a baseline diagnosis of AD with a mild degree of dementia were included (n = 155).…”

Section: Methodsmentioning

confidence: 99%

“…Two of the authors (MLB and KP) had conducted an interrater reliability analysis of 51 patients including eight different diagnoses, demonstrating very good interrater agreement for early- and late-onset AD (kappa 0.73 and 0.85 respectively) [ 14 , 15 ]. Therefore, patients with AD were diagnosed by one of these authors alone or by two other authors in consensus (RSE and IS), according to the ICD-10 and NINCDS-ADRDA criteria based on all available clinical information, without knowledge of the results of the MRI visual rating scales.…”

Section: Methodsmentioning

confidence: 99%

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MRI-assessed atrophy subtypes in Alzheimer’s disease and the cognitive reserve hypothesis

et al. 2017

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Background/AimsMRI assessment of the brain has demonstrated four different patterns of atrophy in patients with Alzheimer’s disease dementia (AD): typical AD, limbic-predominant AD, hippocampal-sparing AD, and a subtype with minimal atrophy, previously referred to as no-atrophy AD. The aim of the present study was to identify and describe the differences between these four AD subtypes in a longitudinal memory-clinic study.MethodsThe medial temporal lobes, the frontal regions, and the posterior regions were assessed with MRI visual rating scales to categorize 123 patients with mild AD according to ICD-10 and NINCDS-ADRDA criteria and the clinical dementia rating scale (CDR) into atrophy subtypes. Demographic data, neuropsychological measures, cerebrospinal-fluid biomarkers, and progression rate of dementia at two-year follow-up were compared between the groups.ResultsTypical AD was found in 59 patients (48%); 29 (24%) patients had limbic-predominant AD; 19 (15%) had hippocampal-sparing AD; and 16 (13%) belonged to the group with minimal atrophy. No differences were found regarding cognitive test results or progression rates between the different subtypes. Using adjusted logistic regression analysis, we found that the patients in the minimal-atrophy group were less educated, had a lower baseline CDR sum of boxes score, and had higher levels of amyloid β in the cerebrospinal fluid.ConclusionPrevious results concerning the prevalence and the similar phenotypic expressions of the four AD subtypes were confirmed. The main finding was that patients with minimal atrophy as assessed by MRI had less education than the other AD subtypes and that this could support the cognitive reserve hypothesis and, at least in part, explain the lower degree of atrophy in this group. Patients with less formal education might present with clinically typical AD symptoms before they have positive biomarkers of AD and this finding might challenge suggested biomarker-based criteria for AD.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

MRI-assessed atrophy subtypes in Alzheimer’s disease and the cognitive reserve hypothesis

et al. 2017

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“…In a previous study, we evaluated NQ as a diagnostic tool in distinguishing AD dementia from non-dementia (subjective and mild cognitive impairment) (6). In 56 of the patients from this study, MTA scores based on the Scheltens MTA scale were available (7). These 56 patients are included in the present study.…”

Section: Methodsmentioning

confidence: 99%

Comparison of automated volumetry of the hippocampus using NeuroQuant® and visual assessment of the medial temporal lobe in Alzheimer’s disease

et al. 2017

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Background Different clinically feasible methods for evaluation of medial temporal lobe atrophy exists and are useful in diagnostic work-up of Alzheimer's disease (AD). Purpose To compare the diagnostic properties of two clinically available magnetic resonance imaging (MRI)-based methods-an automated volumetric software, NeuroQuant® (NQ) (evaluation of hippocampus volume) and the Scheltens scale (visual evaluation of medial temporal lobe atrophy [MTA])-in patients with AD dementia, and subjective and mild cognitive impairment (non-dementia). Material and Methods MRIs from 56 patients (31 AD, 25 non-dementia) were assessed with both methods. Correlations between the methods were calculated and receiver operating curve (ROC) analyses that yield area under the curve (AUC) statistics were conducted. Results High correlations were found between the two MRI assessments for the total hippocampal volume measured with NQ and mean MTA score (-0.753, P < 0.001), for the right (-0.767, P < 0.001), and for the left (-0.675, P < 0.001) sides. The NQ total measure yielded somewhat higher AUC (0.88, "good") compared to the MTA mean measure (0.80, "good") in the comparison of patients with AD and non-dementia, but the accuracy was in favor of the MTA scale. Conclusion The two methods correlated highly and both methods reached equally "good" power.

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“…The use of MTA has shown high accuracy in determining the severity of local atrophy in cross-sectional studies that compared AD patients against healthy controls (Ridha et al, 2007). Conversely, MTA appears to be poorly informative in detecting longitudinal volumetric changes over time (Ridha et al, 2007;Persson et al, 2017). There have been introduced specific visual rating scales also to quantify the presence and severity of macroscopic white matter (WM) abnormalities.…”

Section: Neuroimaging Markersmentioning

confidence: 99%

Early diagnosis of Alzheimer’s disease: the role of biomarkers including advanced EEG signal analysis. Report from the IFCN-sponsored panel of experts

Rossini

Iorio

Vecchio

et al. 2020

Clinical Neurophysiology

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106

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Alzheimer's disease (AD) is the most common neurodegenerative disease among the elderly with a progressive decline in cognitive function significantly affecting quality of life. Both the prevalence and emotional and financial burdens of AD on patients, their families, and society are predicted to grow significantly in the near future, due to a prolongation of the lifespan. Several lines of evidence suggest that modifications of risk-enhancing life styles and initiation of pharmacological and nonpharmacological treatments in the early stage of disease, although not able to modify its course, helps to maintain personal autonomy in daily activities and significantly reduces the total costs of disease management. Moreover, many clinical trials with potentially disease-modifying drugs are devoted to prodromal stages of AD. Thus, the identification of markers of conversion from prodromal form to clinically AD may be crucial for developing strategies of early interventions. The current available markers, including volumetric MRI, PET, and CSF analysis are expensive, poorly available in community health facilities, and relatively invasive. Taking into account its low cost, widespread availability and non-invasiveness, EEG would represent a candidate for tracking the prodromal phases of cognitive decline in routine clinical settings eventually in combination with other markers. After providing a short overview of the epidemiology andmarkers in AD, this review aimed to explore whether advanced analysis of EEG rhythms exploring brain function has sufficient specificity/sensitivity/accuracy to screen out the risk of conversion from Mild cognitive Impairment (MCI, a condition which is prodromal to AD in a high percentage of cases) to AD as a first-level screening method. HIGHLIGHTSThis review describes an integrated and multidisciplinary approach for the "early" diagnosis of AD.An overview of epidemiology, genetic risk factors, and different biomarkers of AD is provided.Analysis of EEG rhythms could represent a valid screening tool to predict AD conversion.

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Visual Evaluation of Medial Temporal Lobe Atrophy as a Clinical Marker of Conversion from Mild Cognitive Impairment to Dementia and for Predicting Progression in Patients with Mild Cognitive Impairment and Mild Alzheimer's Disease

Cited by 13 publications

References 42 publications

MRI-assessed atrophy subtypes in Alzheimer’s disease and the cognitive reserve hypothesis

MRI-assessed atrophy subtypes in Alzheimer’s disease and the cognitive reserve hypothesis

Comparison of automated volumetry of the hippocampus using NeuroQuant® and visual assessment of the medial temporal lobe in Alzheimer’s disease

Early diagnosis of Alzheimer’s disease: the role of biomarkers including advanced EEG signal analysis. Report from the IFCN-sponsored panel of experts

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