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Medial temporal lobe atrophy on MRI scans and the diagnosis of Alzheimer disease.
Neurology 2008; 71(24):1986-92Neur

Abstract

BACKGROUND

Despite convenience, accessibility, and strong correlation to severity of Alzheimer disease (AD) pathology, medial temporal lobe atrophy (MTA) has not been used as a criterion in the diagnosis of prodromal and probable AD.

METHODS

Using a newly validated visual rating system, mean MTA scores of three bilateral medial temporal lobe structures were compared for subjects with no cognitive impairment (NCI) (n = 117), nonamnestic mild cognitive impairment (MCI) (n = 46), amnestic MCI (n = 45), and probable AD (n = 53). Correlations between MTA scores and neuropsychological test scores at baseline, and predictors of change in diagnosis at 1-year follow-up were evaluated.

RESULTS

With NCI as the reference group, a mean MTA cut score of 1.33 yielded an optimal sensitivity/specificity of 85%/82% for probable AD subjects and 80%/82% for amnestic MCI subjects. MTA and Clinical Dementia Rating Sum of Boxes scores at baseline were independent and additive predictors of diagnosis at baseline, and of transition from NCI to MCI or from MCI to dementia at 1-year follow-up.

CONCLUSION

Medial temporal lobe atrophy (MTA) scores 1) distinguish probable Alzheimer disease (AD) and amnestic mild cognitive impairment (MCI) subjects from nonamnestic MCI and no cognitive impairment (NCI) subjects, 2) help predict diagnosis at baseline, and 3) predict transition from NCI to MCI and from MCI to probable AD. MTA scores should be used as a criterion in the clinical diagnosis of AD.

Authors+Show Affiliations

Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, 4300 Alton Rd., Miami Beach, FL 33140, USA. ranjan-duara@msmc.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19064880

Citation

Duara, R, et al. "Medial Temporal Lobe Atrophy On MRI Scans and the Diagnosis of Alzheimer Disease." Neurology, vol. 71, no. 24, 2008, pp. 1986-92.
Duara R, Loewenstein DA, Potter E, et al. Medial temporal lobe atrophy on MRI scans and the diagnosis of Alzheimer disease. Neurology. 2008;71(24):1986-92.
Duara, R., Loewenstein, D. A., Potter, E., Appel, J., Greig, M. T., Urs, R., ... Potter, H. (2008). Medial temporal lobe atrophy on MRI scans and the diagnosis of Alzheimer disease. Neurology, 71(24), pp. 1986-92. doi:10.1212/01.wnl.0000336925.79704.9f.
Duara R, et al. Medial Temporal Lobe Atrophy On MRI Scans and the Diagnosis of Alzheimer Disease. Neurology. 2008 Dec 9;71(24):1986-92. PubMed PMID: 19064880.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Medial temporal lobe atrophy on MRI scans and the diagnosis of Alzheimer disease. AU - Duara,R, AU - Loewenstein,D A, AU - Potter,E, AU - Appel,J, AU - Greig,M T, AU - Urs,R, AU - Shen,Q, AU - Raj,A, AU - Small,B, AU - Barker,W, AU - Schofield,E, AU - Wu,Y, AU - Potter,H, PY - 2008/12/10/pubmed PY - 2009/1/10/medline PY - 2008/12/10/entrez SP - 1986 EP - 92 JF - Neurology JO - Neurology VL - 71 IS - 24 N2 - BACKGROUND: Despite convenience, accessibility, and strong correlation to severity of Alzheimer disease (AD) pathology, medial temporal lobe atrophy (MTA) has not been used as a criterion in the diagnosis of prodromal and probable AD. METHODS: Using a newly validated visual rating system, mean MTA scores of three bilateral medial temporal lobe structures were compared for subjects with no cognitive impairment (NCI) (n = 117), nonamnestic mild cognitive impairment (MCI) (n = 46), amnestic MCI (n = 45), and probable AD (n = 53). Correlations between MTA scores and neuropsychological test scores at baseline, and predictors of change in diagnosis at 1-year follow-up were evaluated. RESULTS: With NCI as the reference group, a mean MTA cut score of 1.33 yielded an optimal sensitivity/specificity of 85%/82% for probable AD subjects and 80%/82% for amnestic MCI subjects. MTA and Clinical Dementia Rating Sum of Boxes scores at baseline were independent and additive predictors of diagnosis at baseline, and of transition from NCI to MCI or from MCI to dementia at 1-year follow-up. CONCLUSION: Medial temporal lobe atrophy (MTA) scores 1) distinguish probable Alzheimer disease (AD) and amnestic mild cognitive impairment (MCI) subjects from nonamnestic MCI and no cognitive impairment (NCI) subjects, 2) help predict diagnosis at baseline, and 3) predict transition from NCI to MCI and from MCI to probable AD. MTA scores should be used as a criterion in the clinical diagnosis of AD. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/19064880/Medial_temporal_lobe_atrophy_on_MRI_scans_and_the_diagnosis_of_Alzheimer_disease_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=19064880 DB - PRIME DP - Unbound Medicine ER -