| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Department of Radiology, Image Analysis Center and Alzheimer Center (W.J.P.H., J.D.S., I.C.S., H.V., F.B.), and Department of Neurology and Alzheimer Center (W.M.v.d.F., P.S.), VU University Medical Center, Amsterdam, The Netherlands; and Dementia Research Centre (J.B., N.C.F.), University College London, Institute of Neurology, UK.
Address correspondence and reprint requests to DrP. Henneman, Department of Radiology and Alzheimer Center, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands w.henneman{at}vumc.nl
Objective: To investigate the added value of hippocampal atrophy rates over whole brain volume measurements on MRI in patients with Alzheimer disease (AD), patients with mild cognitive impairment (MCI), and controls.
Methods: We included 64 patients with AD (67 ± 9 years; F/M 38/26), 44 patients with MCI (71 ± 6 years; 21/23), and 34 controls (67 ± 9 years; 16/18). Two MR scans were performed (scan interval: 1.8 ± 0.7 years; 1.0 T), using a coronal three-dimensional T1-weighted gradient echo sequence. At follow-up, 3 controls and 23 patients with MCI had progressed to AD. Hippocampi were manually delineated at baseline. Hippocampal atrophy rates were calculated using regional, nonlinear fluid registration. Whole brain baseline volumes and atrophy rates were determined using automated segmentation and registration tools.
Results: All MRI measures differed between groups (p < 0.005). For the distinction of MCI from controls, larger effect sizes of hippocampal measures were found compared to whole brain measures. Between MCI and AD, only whole brain atrophy rate differed significantly. Cox proportional hazards models (variables dichotomized by median) showed that within all patients without dementia, hippocampal baseline volume (hazard ratio [HR]: 5.7 [95% confidence interval: 1.5–22.2]), hippocampal atrophy rate (5.2 [1.9–14.3]), and whole brain atrophy rate (2.8 [1.1–7.2]) independently predicted progression to AD; the combination of low hippocampal volume and high atrophy rate yielded a HR of 61.1 (6.1–606.8). Within patients with MCI, only hippocampal baseline volume and atrophy rate predicted progression.
Conclusion: Hippocampal measures, especially hippocampal atrophy rate, best discriminate mild cognitive impairment (MCI) from controls. Whole brain atrophy rate discriminates Alzheimer disease (AD) from MCI. Regional measures of hippocampal atrophy are the strongest predictors of progression to AD.
AD = Alzheimer disease; BET = brain extraction tool; CI = confidence interval; df = degrees of freedom; FTLD = frontotemporal lobar degeneration; HR = hazard ratio; MCI = mild cognitive impairment; MMSE = Mini-Mental State Examination; NBV = normalized brain volume; PBVC = percentage brain volume change; ROI = region of interest; VaD = vascular dementia; VAT = visual association test.
Disclosure: The authors report no disclosures.
Received September 10, 2008. Accepted in final form December 16, 2008.
This article has been cited by other articles:
|
|
 |
|
  S. R. Choi, G. Golding, Z. Zhuang, W. Zhang, N. Lim, F. Hefti, T. E. Benedum, M. R. Kilbourn, D. Skovronsky, and H. F. Kung Preclinical Properties of 18F-AV-45: A PET Agent for A{beta} Plaques in the Brain J. Nucl. Med., November 1, 2009; 50(11): 1887 - 1894. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W.J.P. Henneman, H. Vrenken, J. Barnes, I. C. Sluimer, N. A. Verwey, M. A. Blankenstein, M. Klein, N. C. Fox, P. Scheltens, F. Barkhof, et al. Baseline CSF p-tau levels independently predict progression of hippocampal atrophy in Alzheimer disease Neurology, September 22, 2009; 73(12): 935 - 940. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
