Medial temporal lobe atrophy on MRI scans and the diagnosis of Alzheimer disease
Medial temporal lobe atrophy on MRI scans and the diagnosis of Alzheimer disease
复制标题
DOI：
10.1212/01.wnl.0000336925.79704.9f
复制
发表时间：
2008-12-09
期刊：
影响因子：
9.9
通讯作者：
Potter, H.
中科院分区：
文献类型：
--
作者：
Duara, R.;Loewenstein, D. A.;Potter, H.
背景：尽管内侧颞叶萎缩(MTA)与阿尔茨海默病(AD)的病理严重程度密切相关，且简便易行，但内侧颞叶萎缩(MTA)尚未被用作诊断先兆和可能AD的标准。方法：使用新验证的视觉评分系统，比较无认知损害(NCI)(n=117)、非遗忘性轻度认知损害(MCI)(n=46)、遗忘性MCI(n=45)和可能AD(n=53)的受试者双侧内侧颞叶结构的平均MTA得分。结果：以NCI为参照组，平均MTA减分值为1.33，对疑似AD患者和遗忘型MCI患者的最佳敏感性/特异性分别为85%/82%和80%/82%。结论：内侧颞叶萎缩(MTA)评分1)区分可能的阿尔茨海默病(AD)和遗忘性轻度认知损害(MCI)与非遗忘性MCI和无认知损害(NCI)的患者，2)帮助预测基线诊断，3)从NCI到MCI和从MCI到可能的AD的预测。MTA评分可作为临床诊断AD的一项指标。神经病学(R)2008；71：1986-1992
Background: Despite convenience, accessibility, and strong correlation to severity of Alzheimer disease (AD) pathology, medial temporal lobe atrophy (MTA) has not been used as a criterion in the diagnosis of prodromal and probable AD.Methods: Using a newly validated visual rating system, mean MTA scores of three bilateral medial temporal lobe structures were compared for subjects with no cognitive impairment (NCI) (n = 117), nonamnestic mild cognitive impairment (MCI) (n = 46), amnestic MCI ( n = 45), and probable AD (n = 53). Correlations between MTA scores and neuropsychological test scores at baseline, and predictors of change in diagnosis at 1-year follow-up were evaluated.Results: With NCI as the reference group, a mean MTA cut score of 1.33 yielded an optimal sensitivity/specificity of 85%/82% for probable AD subjects and 80%/82% for amnestic MCI subjects. MTA and Clinical Dementia Rating Sum of Boxes scores at baseline were independent and additive predictors of diagnosis at baseline, and of transition from NCI to MCI or from MCI to dementia at 1-year follow-up.Conclusion: Medial temporal lobe atrophy (MTA) scores 1) distinguish probable Alzheimer disease (AD) and amnestic mild cognitive impairment (MCI) subjects from nonamnestic MCI and no cognitive impairment (NCI) subjects, 2) help predict diagnosis at baseline, and 3) predict transition from NCI to MCI and from MCI to probable AD. MTA scores should be used as a criterion in the clinical diagnosis of AD. Neurology (R) 2008;71:1986-1992