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Published in: European Radiology 4/2018

Open Access 01-04-2018 | Neuro

Medial temporal lobe atrophy ratings in a large 75-year-old population-based cohort: gender-corrected and education-corrected normative data

Authors: V. Velickaite, D. Ferreira, L. Cavallin, L. Lind, H. Ahlström, L. Kilander, E. Westman, E.-M. Larsson

Published in: European Radiology | Issue 4/2018

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Abstract

Objectives

To find cut-off values for different medial temporal lobe atrophy (MTA) measures (right, left, average, and highest), accounting for gender and education, investigate the association with cognitive performance, and to compare with decline of cognitive function over 5 years in a large population-based cohort.

Methods

Three hundred and ninety 75-year-old individuals were examined with magnetic resonance imaging of the brain and cognitive testing. The Scheltens’s scale was used to assess visually MTA scores (0–4) in all subjects. Cognitive tests were repeated in 278 of them after 5 years. Normal MTA cut-off values were calculated based on the 10th percentile.

Results

Most 75-year-old individuals had MTA score ≤2. Men had significantly higher MTA scores than women. Scores for left and average MTA were significantly higher in highly educated individuals. Abnormal MTA was associated with worse results in cognitive test and individuals with abnormal right MTA had faster cognitive decline.

Conclusion

At age 75, gender and education are confounders for MTA grading. A score of ≥2 is abnormal for low-educated women and a score of ≥2.5 is abnormal for men and high-educated women. Subjects with abnormal right MTA, but normal MMSE scores had developed worse MMSE scores 5 years later.

Key Points

Gender and education are confounders for MTA grading.
We suggest cut-off values for 75-year-olds, taking gender and education into account.
Males have higher MTA scores than women.
Higher MTA scores are associated with worse cognitive performance.
Literature
1.
go back to reference Dubois B, Feldman HH, Jacova C et al (2007) Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS-ADRDA criteria. Lancet Neurol 6:734–746CrossRefPubMed Dubois B, Feldman HH, Jacova C et al (2007) Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS-ADRDA criteria. Lancet Neurol 6:734–746CrossRefPubMed
2.
go back to reference Cavallin L, Bronge L, Zhang Y et al (2012) Comparison between visual assessment of MTA and hippocampal volumes in an elderly, non-demented population. Acta Radiologica 53:573–579CrossRefPubMed Cavallin L, Bronge L, Zhang Y et al (2012) Comparison between visual assessment of MTA and hippocampal volumes in an elderly, non-demented population. Acta Radiologica 53:573–579CrossRefPubMed
3.
go back to reference Visser PJ, Verhey FR, Hofman PA, Scheltens P, Jolles J (2002) Medial temporal lobe atrophy predicts Alzheimer's disease in patients with minor cognitive impairment. J Neurol Neurosurg Psychiatry 72:491–497PubMedPubMedCentral Visser PJ, Verhey FR, Hofman PA, Scheltens P, Jolles J (2002) Medial temporal lobe atrophy predicts Alzheimer's disease in patients with minor cognitive impairment. J Neurol Neurosurg Psychiatry 72:491–497PubMedPubMedCentral
4.
go back to reference Whitwell JL, Shiung MM, Przybelski SA et al (2008) MRI patterns of atrophy associated with progression to AD in amnestic mild cognitive impairment. Neurology 70:512–520CrossRefPubMed Whitwell JL, Shiung MM, Przybelski SA et al (2008) MRI patterns of atrophy associated with progression to AD in amnestic mild cognitive impairment. Neurology 70:512–520CrossRefPubMed
5.
go back to reference McKhann GM, Knopman DS, Chertkow H et al (2011) The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement 7:263–269CrossRefPubMedPubMedCentral McKhann GM, Knopman DS, Chertkow H et al (2011) The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement 7:263–269CrossRefPubMedPubMedCentral
6.
go back to reference Jack CR Jr, Albert MS, Knopman DS et al (2011) Introduction to the recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement 7:257–262CrossRefPubMedPubMedCentral Jack CR Jr, Albert MS, Knopman DS et al (2011) Introduction to the recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement 7:257–262CrossRefPubMedPubMedCentral
7.
go back to reference Jack CR Jr, Dickson DW, Parisi JE et al (2002) Antemortem MRI findings correlate with hippocampal neuropathology in typical aging and dementia. Neurology 58:750–757CrossRefPubMedPubMedCentral Jack CR Jr, Dickson DW, Parisi JE et al (2002) Antemortem MRI findings correlate with hippocampal neuropathology in typical aging and dementia. Neurology 58:750–757CrossRefPubMedPubMedCentral
8.
go back to reference Geuze E, Vermetten E, Bremner JD (2005) MR-based in vivo hippocampal volumetrics: 1. Review of methodologies currently employed. Mol Psychiatry 10:147–159CrossRefPubMed Geuze E, Vermetten E, Bremner JD (2005) MR-based in vivo hippocampal volumetrics: 1. Review of methodologies currently employed. Mol Psychiatry 10:147–159CrossRefPubMed
9.
go back to reference Boutet C, Chupin M, Colliot O et al (2012) Is radiological evaluation as good as computer-based volumetry to assess hippocampal atrophy in Alzheimer's disease? Neuroradiology 54:1321–1330CrossRefPubMed Boutet C, Chupin M, Colliot O et al (2012) Is radiological evaluation as good as computer-based volumetry to assess hippocampal atrophy in Alzheimer's disease? Neuroradiology 54:1321–1330CrossRefPubMed
10.
go back to reference Wahlund LO, Westman E, van Westen D et al (2017) Imaging biomarkers of dementia: recommended visual rating scales with teaching cases. Insights Imaging 8:79–90CrossRefPubMed Wahlund LO, Westman E, van Westen D et al (2017) Imaging biomarkers of dementia: recommended visual rating scales with teaching cases. Insights Imaging 8:79–90CrossRefPubMed
11.
go back to reference Westman E, Cavallin L, Muehlboeck JS et al (2011) Sensitivity and specificity of medial temporal lobe visual ratings and multivariate regional MRI classification in Alzheimer's disease. PLoS One 6:e22506CrossRefPubMedPubMedCentral Westman E, Cavallin L, Muehlboeck JS et al (2011) Sensitivity and specificity of medial temporal lobe visual ratings and multivariate regional MRI classification in Alzheimer's disease. PLoS One 6:e22506CrossRefPubMedPubMedCentral
12.
go back to reference Scheltens P, Leys D, Barkhof F et al (1992) Atrophy of medial temporal lobes on MRI in "probable" Alzheimer's disease and normal ageing: diagnostic value and neuropsychological correlates. J Neurol Neurosurg Psychiatry 55:967–972CrossRefPubMedPubMedCentral Scheltens P, Leys D, Barkhof F et al (1992) Atrophy of medial temporal lobes on MRI in "probable" Alzheimer's disease and normal ageing: diagnostic value and neuropsychological correlates. J Neurol Neurosurg Psychiatry 55:967–972CrossRefPubMedPubMedCentral
13.
go back to reference Wattjes MP, Henneman WJ, van der Flier WM et al (2009) Diagnostic imaging of patients in a memory clinic: comparison of MR imaging and 64-detector row CT. Radiology 253:174–183CrossRefPubMed Wattjes MP, Henneman WJ, van der Flier WM et al (2009) Diagnostic imaging of patients in a memory clinic: comparison of MR imaging and 64-detector row CT. Radiology 253:174–183CrossRefPubMed
14.
go back to reference Barkhof F (2011) Neuroimaging in dementia. Springer Verlag, Berlin Heidelberg, pp 43–47CrossRef Barkhof F (2011) Neuroimaging in dementia. Springer Verlag, Berlin Heidelberg, pp 43–47CrossRef
15.
go back to reference Scheltens P, Launer LJ, Barkhof F, Weinstein HC, van Gool WA (1995) Visual assessment of medial temporal lobe atrophy on magnetic resonance imaging: interobserver reliability. J Neurol 242:557–560CrossRefPubMed Scheltens P, Launer LJ, Barkhof F, Weinstein HC, van Gool WA (1995) Visual assessment of medial temporal lobe atrophy on magnetic resonance imaging: interobserver reliability. J Neurol 242:557–560CrossRefPubMed
17.
18.
go back to reference Cavallin L, Loken K, Engedal K et al (2012) Overtime reliability of medial temporal lobe atrophy rating in a clinical setting. Acta Radiol 53:318–323CrossRefPubMed Cavallin L, Loken K, Engedal K et al (2012) Overtime reliability of medial temporal lobe atrophy rating in a clinical setting. Acta Radiol 53:318–323CrossRefPubMed
19.
20.
go back to reference Pereira JB, Cavallin L, Spulber G et al (2014) Influence of age, disease onset and ApoE4 on visual medial temporal lobe atrophy cut-offs. J Intern Med 275:317–330CrossRefPubMed Pereira JB, Cavallin L, Spulber G et al (2014) Influence of age, disease onset and ApoE4 on visual medial temporal lobe atrophy cut-offs. J Intern Med 275:317–330CrossRefPubMed
21.
22.
go back to reference Ystad MA, Lundervold AJ, Wehling E et al (2009) Hippocampal volumes are important predictors for memory function in elderly women. BMC Med Imaging 9:17CrossRefPubMedPubMedCentral Ystad MA, Lundervold AJ, Wehling E et al (2009) Hippocampal volumes are important predictors for memory function in elderly women. BMC Med Imaging 9:17CrossRefPubMedPubMedCentral
23.
go back to reference Zhang Y, Qiu C, Lindberg O et al (2010) Acceleration of hippocampal atrophy in a non-demented elderly population: the SNAC-K study. Int Psychogeriatr 22:14–25CrossRefPubMed Zhang Y, Qiu C, Lindberg O et al (2010) Acceleration of hippocampal atrophy in a non-demented elderly population: the SNAC-K study. Int Psychogeriatr 22:14–25CrossRefPubMed
24.
go back to reference Schoonenboom NS, van der Flier WM, Blankenstein MA et al (2008) CSF and MRI markers independently contribute to the diagnosis of Alzheimer's disease. Neurobiol Aging 29:669–675CrossRefPubMed Schoonenboom NS, van der Flier WM, Blankenstein MA et al (2008) CSF and MRI markers independently contribute to the diagnosis of Alzheimer's disease. Neurobiol Aging 29:669–675CrossRefPubMed
25.
go back to reference Barbier CE, Nylander R, Themudo R et al (2011) Prevalence of unrecognized myocardial infarction detected with magnetic resonance imaging and its relationship to cerebral ischemic lesions in both sexes. J Am Coll Cardiol 58:1372–1377CrossRefPubMed Barbier CE, Nylander R, Themudo R et al (2011) Prevalence of unrecognized myocardial infarction detected with magnetic resonance imaging and its relationship to cerebral ischemic lesions in both sexes. J Am Coll Cardiol 58:1372–1377CrossRefPubMed
26.
go back to reference Hansen T, Wikstrom J, Johansson LO, Lind L, Ahlstrom H (2007) The prevalence and quantification of atherosclerosis in an elderly population assessed by whole-body magnetic resonance angiography. Arterioscler Thromb Vasc Biol 27:649–654CrossRefPubMed Hansen T, Wikstrom J, Johansson LO, Lind L, Ahlstrom H (2007) The prevalence and quantification of atherosclerosis in an elderly population assessed by whole-body magnetic resonance angiography. Arterioscler Thromb Vasc Biol 27:649–654CrossRefPubMed
27.
go back to reference Folstein MF, Folstein SE, McHugh PR (1975) "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198CrossRefPubMed Folstein MF, Folstein SE, McHugh PR (1975) "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198CrossRefPubMed
28.
go back to reference Solomon PR, Hirschoff A, Kelly B et al (1998) A 7 minute neurocognitive screening battery highly sensitive to Alzheimer's disease. Arch Neurol 55:349–355CrossRefPubMed Solomon PR, Hirschoff A, Kelly B et al (1998) A 7 minute neurocognitive screening battery highly sensitive to Alzheimer's disease. Arch Neurol 55:349–355CrossRefPubMed
30.
go back to reference Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed
31.
go back to reference Barnes J, Ridgway GR, Bartlett J et al (2010) Head size, age and gender adjustment in MRI studies: a necessary nuisance? Neuroimage 53:1244–1255CrossRefPubMed Barnes J, Ridgway GR, Bartlett J et al (2010) Head size, age and gender adjustment in MRI studies: a necessary nuisance? Neuroimage 53:1244–1255CrossRefPubMed
32.
go back to reference Pruessner JC, Collins DL, Pruessner M, Evans AC (2001) Age and gender predict volume decline in the anterior and posterior hippocampus in early adulthood. J Neurosci 21:194–200PubMed Pruessner JC, Collins DL, Pruessner M, Evans AC (2001) Age and gender predict volume decline in the anterior and posterior hippocampus in early adulthood. J Neurosci 21:194–200PubMed
33.
go back to reference Perneczky R, Wagenpfeil S, Lunetta KL et al (2009) Education attenuates the effect of medial temporal lobe atrophy on cognitive function in Alzheimer's disease: the MIRAGE study. J Alzheimers Dis 17:855–862CrossRefPubMedPubMedCentral Perneczky R, Wagenpfeil S, Lunetta KL et al (2009) Education attenuates the effect of medial temporal lobe atrophy on cognitive function in Alzheimer's disease: the MIRAGE study. J Alzheimers Dis 17:855–862CrossRefPubMedPubMedCentral
35.
go back to reference Koepsell TD, Kurland BF, Harel O, Johnson EA, Zhou XH, Kukull WA (2008) Education, cognitive function, and severity of neuropathology in Alzheimer disease. Neurology 70:1732–1739CrossRefPubMed Koepsell TD, Kurland BF, Harel O, Johnson EA, Zhou XH, Kukull WA (2008) Education, cognitive function, and severity of neuropathology in Alzheimer disease. Neurology 70:1732–1739CrossRefPubMed
36.
go back to reference Duara R, Loewenstein DA, Potter E et al (2008) Medial temporal lobe atrophy on MRI scans and the diagnosis of Alzheimer disease. Neurology 71:1986–1992CrossRefPubMedPubMedCentral Duara R, Loewenstein DA, Potter E et al (2008) Medial temporal lobe atrophy on MRI scans and the diagnosis of Alzheimer disease. Neurology 71:1986–1992CrossRefPubMedPubMedCentral
37.
go back to reference Henneman WJ, Sluimer JD, Barnes J et al (2009) Hippocampal atrophy rates in Alzheimer disease: added value over whole brain volume measures. Neurology 72:999–1007CrossRefPubMedPubMedCentral Henneman WJ, Sluimer JD, Barnes J et al (2009) Hippocampal atrophy rates in Alzheimer disease: added value over whole brain volume measures. Neurology 72:999–1007CrossRefPubMedPubMedCentral
38.
go back to reference Lucarelli RT, Peshock RM, McColl R et al (2013) MR imaging of hippocampal asymmetry at 3T in a multiethnic, population-based sample: results from the Dallas Heart Study. AJNR Am J Neuroradiol 34:752–757CrossRefPubMed Lucarelli RT, Peshock RM, McColl R et al (2013) MR imaging of hippocampal asymmetry at 3T in a multiethnic, population-based sample: results from the Dallas Heart Study. AJNR Am J Neuroradiol 34:752–757CrossRefPubMed
39.
go back to reference Thompson DK, Wood SJ, Doyle LW, Warfield SK, Egan GF, Inder TE (2009) MR-determined hippocampal asymmetry in full-term and preterm neonates. Hippocampus 19:118–123CrossRefPubMedPubMedCentral Thompson DK, Wood SJ, Doyle LW, Warfield SK, Egan GF, Inder TE (2009) MR-determined hippocampal asymmetry in full-term and preterm neonates. Hippocampus 19:118–123CrossRefPubMedPubMedCentral
40.
go back to reference Tapiola T, Pennanen C, Tapiola M et al (2008) MRI of hippocampus and entorhinal cortex in mild cognitive impairment: a follow-up study. Neurobiol Aging 29:31–38CrossRefPubMed Tapiola T, Pennanen C, Tapiola M et al (2008) MRI of hippocampus and entorhinal cortex in mild cognitive impairment: a follow-up study. Neurobiol Aging 29:31–38CrossRefPubMed
41.
go back to reference Eckerstrom C, Olsson E, Borga M et al (2008) Small baseline volume of left hippocampus is associated with subsequent conversion of MCI into dementia: the Goteborg MCI study. J Neurol Sci 272:48–59CrossRefPubMed Eckerstrom C, Olsson E, Borga M et al (2008) Small baseline volume of left hippocampus is associated with subsequent conversion of MCI into dementia: the Goteborg MCI study. J Neurol Sci 272:48–59CrossRefPubMed
43.
go back to reference Jack CR Jr, Knopman DS, Weigand SD et al (2012) An operational approach to NIA-AA criteria for preclinical Alzheimer’s disease. Ann Neurol 71:765–775CrossRefPubMedPubMedCentral Jack CR Jr, Knopman DS, Weigand SD et al (2012) An operational approach to NIA-AA criteria for preclinical Alzheimer’s disease. Ann Neurol 71:765–775CrossRefPubMedPubMedCentral
Metadata
Title
Medial temporal lobe atrophy ratings in a large 75-year-old population-based cohort: gender-corrected and education-corrected normative data
Authors
V. Velickaite
D. Ferreira
L. Cavallin
L. Lind
H. Ahlström
L. Kilander
E. Westman
E.-M. Larsson
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 4/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5103-6

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