Medial temporal lobe atrophy on MRI differentiates Alzheimer's disease from dementia with Lewy bodies and vascular cognitive impairment: a prospective study with pathological verification of diagnosis - PubMed (original) (raw)
. 2009 Jan;132(Pt 1):195-203.
doi: 10.1093/brain/awn298. Epub 2008 Nov 20.
Affiliations
- PMID: 19022858
- DOI: 10.1093/brain/awn298
Medial temporal lobe atrophy on MRI differentiates Alzheimer's disease from dementia with Lewy bodies and vascular cognitive impairment: a prospective study with pathological verification of diagnosis
E J Burton et al. Brain. 2009 Jan.
Abstract
The purpose of this study was to determine the diagnostic accuracy of medial temporal lobe atrophy (MTA) on MRI for distinguishing Alzheimer's disease from other dementias in autopsy confirmed cases, and to determine pathological correlates of MTA in Alzheimer's disease, dementia with Lewy bodies (DLB) and vascular cognitive impairment (VCI). We studied 46 individuals who had both antemortem MRI and an autopsy. Subjects were clinicopathologically classified as having Alzheimer's disease (n = 11), DLB (n = 23) or VCI (n = 12). MTA was rated visually using a standardized (Scheltens) scale blind to clinical or autopsy diagnosis. Neuropathological analysis included Braak staging as well as quantitative analysis of plaques, tangles and alpha-synuclein Lewy body-associated pathology in the hippocampus. Correlations between MTA and pathological measures were carried out using Spearman's rho, linear regression to assess the contributions of local pathologic changes to MTA. Receiver operator curve analysis was used to assess the diagnostic specificity of MTA for Alzheimer's disease among individuals with Alzheimer's disease, DLB and VCI. MTA was a highly accurate diagnostic marker for autopsy confirmed Alzheimer's disease (sensitivity of 91% and specificity of 94%) compared with DLB and VCI. Across the entire sample, correlations were observed between MTA and Braak stage (rho = 0.50, P < 0.001), per cent area of plaques in the hippocampus (rho = 0.37, P = 0.014) and per cent area of tangles in the hippocampus (rho = 0.49, P = 0.001). Linear regression showed Braak stage (P = 0.022) to be a significant predictor of MTA but not percent area of plaques (P = 0.375), percent area of tangles (P = 0.330) or percent area of Lewy bodies (P = 0.086). MTA on MRI had robust discriminatory power for distinguishing Alzheimer's disease from DLB and VCI in pathologically confirmed cases. Pathologically, it is more strongly related to tangle rather than plaque or Lewy body pathology in the temporal lobe. It may have utility as a means for stratifying samples in vivo on the basis of putative differences in pathology.
Similar articles
- Temporal lobe atrophy on MRI in Parkinson disease with dementia: a comparison with Alzheimer disease and dementia with Lewy bodies.
Tam CW, Burton EJ, McKeith IG, Burn DJ, O'Brien JT. Tam CW, et al. Neurology. 2005 Mar 8;64(5):861-5. doi: 10.1212/01.WNL.0000153070.82309.D4. Neurology. 2005. PMID: 15753423 - Pattern of brain atrophy rates in autopsy-confirmed dementia with Lewy bodies.
Nedelska Z, Ferman TJ, Boeve BF, Przybelski SA, Lesnick TG, Murray ME, Gunter JL, Senjem ML, Vemuri P, Smith GE, Geda YE, Graff-Radford J, Knopman DS, Petersen RC, Parisi JE, Dickson DW, Jack CR Jr, Kantarci K. Nedelska Z, et al. Neurobiol Aging. 2015 Jan;36(1):452-61. doi: 10.1016/j.neurobiolaging.2014.07.005. Epub 2014 Jul 15. Neurobiol Aging. 2015. PMID: 25128280 Free PMC article. - White matter hyperintensities on MRI in dementia with Lewy bodies, Parkinson's disease with dementia, and Alzheimer's disease.
Joki H, Higashiyama Y, Nakae Y, Kugimoto C, Doi H, Kimura K, Kishida H, Ueda N, Nakano T, Takahashi T, Koyano S, Takeuchi H, Tanaka F. Joki H, et al. J Neurol Sci. 2018 Feb 15;385:99-104. doi: 10.1016/j.jns.2017.12.018. Epub 2017 Dec 19. J Neurol Sci. 2018. PMID: 29406924 - Dementia with Lewy bodies.
McKeith IG, Burn DJ, Ballard CG, Collerton D, Jaros E, Morris CM, McLaren A, Perry EK, Perry R, Piggott MA, O'Brien JT. McKeith IG, et al. Semin Clin Neuropsychiatry. 2003 Jan;8(1):46-57. doi: 10.1053/scnp.2003.50006. Semin Clin Neuropsychiatry. 2003. PMID: 12567332 Review. - Dementia with Lewy bodies: diagnosis and management.
Barber R, Panikkar A, McKeith IG. Barber R, et al. Int J Geriatr Psychiatry. 2001 Dec;16 Suppl 1:S12-8. doi: 10.1002/1099-1166(200112)16:1+<::aid-gps562>3.0.co;2-3. Int J Geriatr Psychiatry. 2001. PMID: 11748785 Review.
Cited by
- The Role of Cilostazol and Inflammation in Cognitive Impairment After Ischemic Stroke.
Huang LC, Hsieh SW, Tsai CC, Chen CH, Yang YH. Huang LC, et al. Am J Alzheimers Dis Other Demen. 2021 Jan-Dec;36:15333175211016185. doi: 10.1177/15333175211016185. Am J Alzheimers Dis Other Demen. 2021. PMID: 34008421 Free PMC article. - Cross-Sectional Association Between Blood Cell Phenotypes, Cognitive Function, and Brain Imaging Measures in the Community-Based Framingham Heart Study.
Fang Y, Doyle MF, Alosco ML, Mez J, Satizabal CL, Qiu WQ, Lunetta KL, Murabito JM. Fang Y, et al. J Alzheimers Dis. 2022;87(3):1291-1305. doi: 10.3233/JAD-215533. J Alzheimers Dis. 2022. PMID: 35431244 Free PMC article. - A Two-Stage Model for Predicting Mild Cognitive Impairment to Alzheimer's Disease Conversion.
Lu P, Hu L, Zhang N, Liang H, Tian T, Lu L. Lu P, et al. Front Aging Neurosci. 2022 Mar 21;14:826622. doi: 10.3389/fnagi.2022.826622. eCollection 2022. Front Aging Neurosci. 2022. PMID: 35386114 Free PMC article. - Difficulty processing temporary syntactic ambiguities in Lewy body spectrum disorder.
Grossman M, Gross RG, Moore P, Dreyfuss M, McMillan CT, Cook PA, Ash S, Siderowf A. Grossman M, et al. Brain Lang. 2012 Jan;120(1):52-60. doi: 10.1016/j.bandl.2011.08.007. Epub 2011 Sep 29. Brain Lang. 2012. PMID: 21962945 Free PMC article. - Effect of cerebral amyloid angiopathy on brain iron, copper, and zinc in Alzheimer's disease.
Schrag M, Crofton A, Zabel M, Jiffry A, Kirsch D, Dickson A, Mao XW, Vinters HV, Domaille DW, Chang CJ, Kirsch W. Schrag M, et al. J Alzheimers Dis. 2011;24(1):137-49. doi: 10.3233/JAD-2010-101503. J Alzheimers Dis. 2011. PMID: 21187585 Free PMC article.