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Discriminating accuracy of medial temporal lobe volumetry and fMRI in mild cognitive impairment.
Hippocampus. 2009 Feb; 19(2):166-75.H

Abstract

We investigated structural and functional changes in the medial temporal lobe (MTL) using magnetic resonance imaging (MRI) and compared the discriminative power of these measures with neuropsychological testing in mild cognitive impairment (MCI) and Alzheimer's disease (AD). Functional MRI (fMRI) was performed in 21 elderly controls, 14 MCI subjects, and 15 mild AD patients during encoding and cued retrieval of word-picture pairs. A region-of-interest-based approach in SPM2 was used to extract the extent of hippocampal activation. The volumes of the hippocampus and entorhinal cortex (EC) were manually outlined from anatomical MR images. Discriminant analyses were conducted to assess the ability of hippocampal fMRI, MTL volumetry, and neuropsychological measures to classify subjects into clinical groups. Entorhinal but not hippocampal volumes differed significantly between the control and MCI subjects. Both entorhinal and hippocampal volumes differed between MCI and AD patients. There were no significant differences in the extent of hippocampal fMRI activation during encoding or retrieval between the groups. Entorhinal volume was the best discriminator with a discriminating accuracy of 85.7% between controls and MCI, 86.2% between MCI and AD, and 97.2% between controls and AD. Delayed recall of a wordlist classified the subjects, second best, with a discriminating accuracy of 81.8% between controls and MCI, 75% between MCI and AD and 93.5% between controls and AD. The accuracy of hippocampal volumetry ranged from 42.9 to 69.4%, and hippocampal fMRI activation during encoding and retrieval had a classification accuracy of only 41.4-57.7% between the groups. Our results suggest that evaluation of entorhinal atrophy, in addition to the prevailing diagnostic criteria, seems promising in the identification of prodromal AD. Future technical improvements may improve the utilization of hippocampal fMRI for early diagnostic purposes.

Authors+Show Affiliations

Institute of Clinical Medicine, Unit of Neurology, University of Kuopio, Kuopio, Finland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18777563

Citation

Jauhiainen, Anne M., et al. "Discriminating Accuracy of Medial Temporal Lobe Volumetry and fMRI in Mild Cognitive Impairment." Hippocampus, vol. 19, no. 2, 2009, pp. 166-75.
Jauhiainen AM, Pihlajamäki M, Tervo S, et al. Discriminating accuracy of medial temporal lobe volumetry and fMRI in mild cognitive impairment. Hippocampus. 2009;19(2):166-75.
Jauhiainen, A. M., Pihlajamäki, M., Tervo, S., Niskanen, E., Tanila, H., Hänninen, T., Vanninen, R. L., & Soininen, H. (2009). Discriminating accuracy of medial temporal lobe volumetry and fMRI in mild cognitive impairment. Hippocampus, 19(2), 166-75. https://doi.org/10.1002/hipo.20494
Jauhiainen AM, et al. Discriminating Accuracy of Medial Temporal Lobe Volumetry and fMRI in Mild Cognitive Impairment. Hippocampus. 2009;19(2):166-75. PubMed PMID: 18777563.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Discriminating accuracy of medial temporal lobe volumetry and fMRI in mild cognitive impairment. AU - Jauhiainen,Anne M, AU - Pihlajamäki,Maija, AU - Tervo,Susanna, AU - Niskanen,Eini, AU - Tanila,Heikki, AU - Hänninen,Tuomo, AU - Vanninen,Ritva L, AU - Soininen,Hilkka, PY - 2008/9/9/pubmed PY - 2009/2/27/medline PY - 2008/9/9/entrez SP - 166 EP - 75 JF - Hippocampus JO - Hippocampus VL - 19 IS - 2 N2 - We investigated structural and functional changes in the medial temporal lobe (MTL) using magnetic resonance imaging (MRI) and compared the discriminative power of these measures with neuropsychological testing in mild cognitive impairment (MCI) and Alzheimer's disease (AD). Functional MRI (fMRI) was performed in 21 elderly controls, 14 MCI subjects, and 15 mild AD patients during encoding and cued retrieval of word-picture pairs. A region-of-interest-based approach in SPM2 was used to extract the extent of hippocampal activation. The volumes of the hippocampus and entorhinal cortex (EC) were manually outlined from anatomical MR images. Discriminant analyses were conducted to assess the ability of hippocampal fMRI, MTL volumetry, and neuropsychological measures to classify subjects into clinical groups. Entorhinal but not hippocampal volumes differed significantly between the control and MCI subjects. Both entorhinal and hippocampal volumes differed between MCI and AD patients. There were no significant differences in the extent of hippocampal fMRI activation during encoding or retrieval between the groups. Entorhinal volume was the best discriminator with a discriminating accuracy of 85.7% between controls and MCI, 86.2% between MCI and AD, and 97.2% between controls and AD. Delayed recall of a wordlist classified the subjects, second best, with a discriminating accuracy of 81.8% between controls and MCI, 75% between MCI and AD and 93.5% between controls and AD. The accuracy of hippocampal volumetry ranged from 42.9 to 69.4%, and hippocampal fMRI activation during encoding and retrieval had a classification accuracy of only 41.4-57.7% between the groups. Our results suggest that evaluation of entorhinal atrophy, in addition to the prevailing diagnostic criteria, seems promising in the identification of prodromal AD. Future technical improvements may improve the utilization of hippocampal fMRI for early diagnostic purposes. SN - 1098-1063 UR - https://www.unboundmedicine.com/medline/citation/18777563/Discriminating_accuracy_of_medial_temporal_lobe_volumetry_and_fMRI_in_mild_cognitive_impairment_ L2 - https://doi.org/10.1002/hipo.20494 DB - PRIME DP - Unbound Medicine ER -