Atrophy of the medial occipitotemporal, inferior, and middle temporal gyri in non-demented elderly predict decline to Alzheimer’s disease☆
Abstract
Our goal was to ascertain, among normal elderly and individuals with mild cognitive impairment, which temporal lobe neocortical regions predicted decline to dementia of the Alzheimer's type (DAT). Individuals received an MRI at baseline and a clinical and cognitive evaluation at baseline and follow-up. By using the baseline MRI we assessed the anatomical subdivisions of the temporal lobe: anteromedial temporal lobe (hippocampus and parahippocampal gyrus), medial occipitotemporal (fusiform) gyrus, middle and inferior temporal gyri, and superior temporal gyrus. We studied two groups of carefully screened age- and education-matched elderly individuals: 26 normal elderly (NL) and 20 individuals with mild cognitive impairment (MCI). Fourteen individuals (12 from the MCI group and two from the NL group) declined to DAT within the 3.2-year follow-up interval. We used logistic regression analyses to ascertain whether the baseline brain volumes were useful predictors of decline to DAT at follow-up after accounting for age, gender, individual differences in brain size, and other variables known to predict DAT. After accounting for age, gender, and head size, adding the volume of the anteromedial temporal lobe (the aggregate of hippocampus and parahippocampal gyrus) and an index of global atrophy raised the accuracy of overall classification to 80.4%. However, the ability to detect those individuals who declined (sensitivity) was low at 57%. When baseline medial occipitotemporal and the combined middle and inferior temporal gyri were added to the logistic model, the overall classification accuracy reached 95.6% and, most importantly, the sensitivity rose to 92.8%. These data indicate that the medial occipitotemporal and the combined middle and inferior temporal gyri may be the first temporal lobe neocortical sites affected in AD; atrophy in these areas may herald the presence of future AD among nondemented individuals. No other clinical baseline variables examined predicted decline with sensitivities above 71%. The apolipoprotein APOE epsilon4 genotype was not associated with decline.
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Reduced size or glucose metabolism (METglu) in the EC, Hip, temporal neocortex, and posterior cingulate gyrus have been shown to predict the MCI conversion to Alzheimer's disease.
“Reduced size or glucose metabolism (METglu) in the EC (10), Hip (11–16), temporal neocortex (17–20), and posterior cingulate gyrus (16) have been shown to predict the MCI conversion to AD.”
Structural imaging studies report useful hippocampal, EC, and combined medial temporal and temporal neocortex predictors for conversion to AD.
“They report useful hippocampal (11–14), EC (10), and combined medial temporal and temporal neocortex (17) predictors for the conversion.”
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“In the later stages, the disease impacts the medial and inferior temporal lobe, such as the middle temporal gyrus, which regulates semantic memory and language processing, and then later the primary sensory and motor cortex [15].”
- Authors
- Convit, A., de Asis, J., de Leon, M. J., Tarshish, C. Y., De Santi, S., & Rusinek, H.
- Affiliations
- Nathan Kline Institute for Psychiatric Research (US)
- NYU Langone Health (US)
- Corresponding author
- Convit, A
- ORCID
- Venue
- Neurobiology of Aging
- Publisher
- Elsevier BV
- Published
- 2000-01
- Volume
- 21
- Issue
- 1
- Pages
- 19-26
- ISSN
- 0197-4580 (ISSN-L)
- OpenAlex
- W2148046162
- Cited by
- 359
- References
- 46
- Citations by year
- 2026: 7 · 2025: 19 · 2024: 16 · 2023: 10 · 2022: 11 · 2021: 15 · 2020: 14 · 2019: 26 · 2018: 14 · 2017: 5 · 2016: 10 · 2015: 14 · 2014: 17 · 2013: 13 · 2012: 14
- FWCI
- 8.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurobiology of Aging (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (P30 AG 08051, AG 12101, P30AG008051, R01AG013616, AG 13616)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Keywords
- Alzheimer's disease, mild cognitive impairment, inferior temporal gyrus, middle temporal gyrus, temporal lobe atrophy, hippocampus, parahippocampal gyrus, dementia prediction, brain volume, APOE ε4, non-demented elderly
- MeSH terms
- Age Factors, Aged, Alzheimer Disease, Atrophy, Cognition Disorders, Female, Follow-Up Studies, Hippocampus, Humans, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Severity of Illness Index, Sex Factors, Temporal Lobe, Multivariate Analysis, Parahippocampal Gyrus
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