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NEUROLOGY 2006;67:453-460
© 2006 American Academy of Neurology

The contribution of voxel-based morphometry in staging patients with mild cognitive impairment

M. Bozzali, MD, M. Filippi, MD, G. Magnani, MD, M. Cercignani, MPhil, M. Franceschi, MD, E. Schiatti, MD, S. Castiglioni, Psych, R. Mossini, MD, M. Falautano, Psych, G. Scotti, MD, G. Comi, MD and A. Falini, MD

From the Neuroimaging Research Unit (M.B., M. Filippi, M.C.), Department of Neurology (M. Filippi, G.M., E.S., R.M., M. Falautano, G.C.), and Department of Neuroradiology, CERMAC (G.S., A.F.), Scientific Institute and University Ospedale San Raffaele, Milan, Italy; Wellcome Department of Imaging Neuroscience (M.B.) and NMR Research Unit (M.C.), Institute of Neurology, University College of London, London, UK; and Department of Neurology, Multimedica-SantaMaria, Castellanza, Italy (M. Franceschi, S.C.).

Address correspondence and reprint requests to Dr. Marco Bozzali, Wellcome Department of Imaging Neuroscience, Institute of Neurology, University College of London, 12 Queen Square, WC1N 3BG London, UK; e-mail: m.bozzali{at}fil.ion.ucl.ac.uk

Objective: To assess whether different patterns of regional gray matter loss in patients with mild cognitive impairment (MCI) are associated with different risks of conversion to Alzheimer disease (AD), using MRI and voxel-based morphometry (VBM).

Methods: The authors recruited 22 patients with MCI, 22 patients with probable AD, and 20 healthy subjects (HS). T1 volumes from each subject were postprocessed according to an optimized VBM protocol. All patients were clinically followed up (mean [SD] time = 28.7 [5.7] months), and patients with MCI were reclassified into two groups (converters and nonconverters to AD).

Results: When comparing patients with AD to HS, widespread areas of reduced gray matter density were found predominantly in temporal, frontal, and parietal lobes and in the insula. Comparing MCI converters and nonconverters with HS, the converters showed more widespread areas of reduced gray matter density than nonconverters, with a pattern of abnormalities similar to that seen in patients with AD. Conversely, when comparing the same groups with patients with AD, MCI nonconverters showed a pattern of gray matter density similar to that of HS. Areas of decreased gray matter density were also found in MCI converters compared with nonconverters.

Conclusions: Different patterns of gray matter density distribution in patients with mild cognitive impairment may be associated to different rates of conversion to Alzheimer disease.

Disclosure: The authors report no conflicts of interest.

Received October 18, 2005. Accepted in final form April 4, 2006.




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