Journal
DEMENTIA AND GERIATRIC COGNITIVE DISORDERS
Volume 14, Issue 4, Pages 198-207Publisher
KARGER
DOI: 10.1159/000066021
Keywords
Alzheimer's disease; mild cognitive impairment; H-1 MRS; diffusion-weighted imaging; hippocampal volumetry; MRI
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Funding
- NIA NIH HHS [AG11378, R01 AG011378-10, P50 AG016574-03, U01 AG006786, R01 AG011378, AG16574, P50 AG016574, U01 AG006786-18, AG06786] Funding Source: Medline
- NATIONAL INSTITUTE ON AGING [U01AG006786, P50AG016574, R01AG011378] Funding Source: NIH RePORTER
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This study compares the diagnostic accuracy of magnetic resonance (MR)-based hippocampal volumetry, single voxel H-1 MR spectroscopy (H-1 MRS) and MR diffusion-weighted imaging (DWI) measurements in discriminating patients with amnestic mild cognitive impairment (MCI), Alzheimer's disease (AD) and normally aging elderly. Sixty-one normally aging elderly, 24 MCI and 22 AD patients underwent MR-based hippocampal volumetry, H-1 MRS and DWI. H-1 MRS voxels were placed over both of the posterior cingulate gyri, and N-acetyl aspartate (NAA)/creatine (Cr), myoinositol (MI)/Cr and NAA/MI ratios were obtained. Apparent diffusion coefficient (ADC) maps were derived from DWI, and hippocampal borders were traced to measure hippocampal ADC. At 80% specificity, the most sensitive single measurement to discriminate MCI (79%) and AD (86%) from controls was hippocampal volumes. The most sensitive single measurement to discriminate AD from MCI was posterior cingulate gyrus NAA/Cr (67%). At high specificity (>85-90%), combinations of MR measures had superior diagnostic sensitivity compared with any single MR measurement for the AD vs. control and control vs. MCI comparisons. The MR measures that best discriminate more from less affected individuals along the cognitive continuum from normal to AD vary with disease severity. Selection of imaging measures used for clinical assessment or monitoring efficiency of therapeutic intervention should be tailored to the clinical stage of the disease. Copyright (C) 2002 S. Karger AG, Basel.
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