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Differential cortical atrophy in subgroups of mild cognitive impairment.
Arch Neurol 2005; 62(9):1393-7AN

Abstract

OBJECTIVE

To compare gray matter brain volumes in patients diagnosed with subtypes of mild cognitive impairment (MCI) (those with a focal amnestic disorder and those with more diffuse cognitive dysfunction) with those of elderly controls.

DESIGN

Magnetic resonance imaging volumetric study of MCI subgroups (MCI-amnestic [MCI-A], and MCI-multiple cognitive domain [MCI-MCD]) using a whole brain voxel-based analysis.

SETTING

Referral dementia clinic. Patients Thirty-seven patients with MCI (age range, 49-85 years; MCI-A, n = 9; MCI-MCD, n = 28) and 47 control subjects (age range, 55-81 years).

MAIN OUTCOME MEASURES

Volumetric anatomical magnetic resonance imaging differences between MCI subgroups and normal controls, and between patients with MCI who progressed to dementia. Magnetic resonance imaging scans were analyzed using statistical software SPM99.

RESULTS

Overall, the patients with MCI had significantly decreased volume in the hippocampus and middle temporal gyrus, bilaterally, compared with control subjects. Compared with patients with MCI-MCD, patients with MCI-A had significant volume loss of the left entorhinal cortex and inferior parietal lobe. Compared with patients with MCI-A, patients with MCI-MCD had significantly reduced volume of the right inferior frontal gyrus, right middle temporal gyrus, and bilateral superior temporal gyrus. Patients with MCI who progressed to Alzheimer disease during follow-up (mean interval 2 years, maximum 4.5 years), showed greater atrophy in the left entorhinal cortex, bilateral superior temporal gyri, and right inferior frontal gyrus compared with those who did not progress.

CONCLUSIONS

These data provide evidence of distinct brain structural abnormalities in 2 groups of patients with MCI. While both have mesial temporal and cortical volume loss, those with a focal memory deficit have more involvement of the mesial temporal structures and less involvement of the neocortical heteromodal association areas than those patients with MCI with diffuse cognitive dysfunction. Thus, MCI may represent a more heterogeneous group than currently conceived, possibly reflecting 2 different etiological processes to dementia. These data also suggest that these structural abnormalities precede the development of Alzheimer disease.

Authors+Show Affiliations

Department of Psychiatry, University of Pittsburgh Medical Center, PA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

16157746

Citation

Bell-McGinty, Sandra, et al. "Differential Cortical Atrophy in Subgroups of Mild Cognitive Impairment." Archives of Neurology, vol. 62, no. 9, 2005, pp. 1393-7.
Bell-McGinty S, Lopez OL, Meltzer CC, et al. Differential cortical atrophy in subgroups of mild cognitive impairment. Arch Neurol. 2005;62(9):1393-7.
Bell-McGinty, S., Lopez, O. L., Meltzer, C. C., Scanlon, J. M., Whyte, E. M., Dekosky, S. T., & Becker, J. T. (2005). Differential cortical atrophy in subgroups of mild cognitive impairment. Archives of Neurology, 62(9), pp. 1393-7.
Bell-McGinty S, et al. Differential Cortical Atrophy in Subgroups of Mild Cognitive Impairment. Arch Neurol. 2005;62(9):1393-7. PubMed PMID: 16157746.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differential cortical atrophy in subgroups of mild cognitive impairment. AU - Bell-McGinty,Sandra, AU - Lopez,Oscar L, AU - Meltzer,Carolyn Cidis, AU - Scanlon,Joelle M, AU - Whyte,Ellen M, AU - Dekosky,Steven T, AU - Becker,James T, PY - 2005/9/15/pubmed PY - 2005/11/15/medline PY - 2005/9/15/entrez SP - 1393 EP - 7 JF - Archives of neurology JO - Arch. Neurol. VL - 62 IS - 9 N2 - OBJECTIVE: To compare gray matter brain volumes in patients diagnosed with subtypes of mild cognitive impairment (MCI) (those with a focal amnestic disorder and those with more diffuse cognitive dysfunction) with those of elderly controls. DESIGN: Magnetic resonance imaging volumetric study of MCI subgroups (MCI-amnestic [MCI-A], and MCI-multiple cognitive domain [MCI-MCD]) using a whole brain voxel-based analysis. SETTING: Referral dementia clinic. Patients Thirty-seven patients with MCI (age range, 49-85 years; MCI-A, n = 9; MCI-MCD, n = 28) and 47 control subjects (age range, 55-81 years). MAIN OUTCOME MEASURES: Volumetric anatomical magnetic resonance imaging differences between MCI subgroups and normal controls, and between patients with MCI who progressed to dementia. Magnetic resonance imaging scans were analyzed using statistical software SPM99. RESULTS: Overall, the patients with MCI had significantly decreased volume in the hippocampus and middle temporal gyrus, bilaterally, compared with control subjects. Compared with patients with MCI-MCD, patients with MCI-A had significant volume loss of the left entorhinal cortex and inferior parietal lobe. Compared with patients with MCI-A, patients with MCI-MCD had significantly reduced volume of the right inferior frontal gyrus, right middle temporal gyrus, and bilateral superior temporal gyrus. Patients with MCI who progressed to Alzheimer disease during follow-up (mean interval 2 years, maximum 4.5 years), showed greater atrophy in the left entorhinal cortex, bilateral superior temporal gyri, and right inferior frontal gyrus compared with those who did not progress. CONCLUSIONS: These data provide evidence of distinct brain structural abnormalities in 2 groups of patients with MCI. While both have mesial temporal and cortical volume loss, those with a focal memory deficit have more involvement of the mesial temporal structures and less involvement of the neocortical heteromodal association areas than those patients with MCI with diffuse cognitive dysfunction. Thus, MCI may represent a more heterogeneous group than currently conceived, possibly reflecting 2 different etiological processes to dementia. These data also suggest that these structural abnormalities precede the development of Alzheimer disease. SN - 0003-9942 UR - https://www.unboundmedicine.com/medline/citation/16157746/Differential_cortical_atrophy_in_subgroups_of_mild_cognitive_impairment_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/archneur.62.9.1393 DB - PRIME DP - Unbound Medicine ER -