The significance of medial temporal lobe atrophy: A postmortem MRI study in the very old
Open accessAbstract
BACKGROUND: Medial temporal lobe atrophy (MTA) is a sensitive radiologic marker for Alzheimer disease (AD) and associated with cognitive impairment. The value of MTA in the oldest old (>85 years old) is largely unknown. METHODS: A total of 132 formalin-fixed brains from the Vantaa 85+ community-based study were subjected to postmortem MRI. Visual ratings of MTA were determined in a blinded fashion and compared with neuropathologic findings and clinical assessment (dementia according to Diagnostic and Statistical Manual of Mental Disorders-III-R). RESULTS: A strong relationship was found between MTA scores and Alzheimer pathology (p < 0.001). The previously proposed cutoff MTA score >2 correctly excluded subjects with no or borderline Alzheimer-type pathology (45/48), but was not very sensitive for AD (modified National Institute on Aging-Reagan Institute criteria). MTA scores >2 were also found in subjects with other primary neurodegenerative hippocampal pathology including hippocampal sclerosis, Lewy-related pathology, and argyrophilic grain disease, either alone or in combination with Alzheimer-type pathology. High MTA scores were associated with clinical dementia-in this subgroup, sensitivity was 63% and specificity 69% for AD. CONCLUSION: Medial temporal lobe atrophy (MTA) on postmortem MRI is sensitive to primary degenerative hippocampal pathology in the very old, but not specific for Alzheimer-type pathology. MTA scores of 2 or less are not frequently associated with dementia.
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Atrophy on MRI likely reflects cumulative loss and shrinkage of the neuropil.
“Atrophy on MRI likely reflects cumulative loss and shrinkage of the neuropil [154–156].”
From NIA‐AA Research Framework: Toward a biological definition of Alzheimer's disease (2018) · cites this paper as [156]
Barkhof et al. found high MTA scores were associated with clinical dementia with sensitivity of 63% and specificity of 69% for AD in post-mortem MRI of 132 autopsy brain tissues.
“Overall, high MTA scores were associated with clinical dementia with sensitivity of 63% and specificity of 69% for AD [23].”
From The use of neuroimaging techniques in the early and differential diagnosis of dementia (2023) · cites this paper as [23]
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References 27 · Cited by 204
- Authors
- Barkhof, F., Polvikoski, T. M., van Straaten, E. C. W., Kalaria, R. N., Sulkava, R., Aronen, H. J., Niinistö, L., Rastas, S., Oinas, M., Scheltens, P., & Erkinjuntti, T.
- Affiliations
- University of Helsinki (FI)
- From the Departments of Radiology (F.B.) and Neurology (E.C.W.v.S., P.S.), VU University Medical Centre, Amsterdam, The Netherlands; Wolfson Centre (T.M.P., R.N.K.), Institute for Ageing and Health, Newcastle General Hospital, Newcastle upon Tyne, UK; School of Public Health and Clinical Nutrition (R.S.), University of Kuopio and Rheumatism Foundation Hospital, Heinola; Department of Radiology (H.J.A.), University of Helsinki, Centre for Military Medicine, the Finnish Defence Forces, Lahti, and...
- Venue
- Neurology
- Published
- 2007-10-09
- Volume
- 69
- Issue
- 15
- Pages
- 1521-1527
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2042247941
- Cited by
- 204
- References
- 27
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 13 · 2023: 15 · 2022: 9 · 2021: 8 · 2020: 16 · 2019: 12 · 2018: 6 · 2017: 8 · 2016: 6 · 2015: 14 · 2014: 10 · 2013: 21 · 2012: 12
- FWCI
- 5.02
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Keywords
- medial temporal lobe atrophy, Alzheimer's disease, postmortem MRI, oldest old, hippocampal pathology, hippocampal sclerosis, argyrophilic grain disease, dementia, sensitivity and specificity, neuropathology
- MeSH terms
- Age Factors, Aged, 80 and over, Aging, Alzheimer Disease, Atrophy, Cognition Disorders, Female, Hippocampus, Humans, Magnetic Resonance Imaging, Male, Predictive Value of Tests, Prognosis, Biomarkers, Disease Progression, Lewy Body Disease
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