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Cited by 256Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsCancer-related cognitive impairment studies

Medial temporal lobe atrophy on MRI scans and the diagnosis of Alzheimer disease

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Duara, R., Loewenstein, D. A., Potter, E., Appel, J., Greig, M. T., Urs, R., Shen, Q., Raj, A. +5 more·2008·Neurology
DOI 10.1212/01.wnl.0000336925.79704.9fPMC PMC2676975
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Abstract

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. AD = Alzheimer disease; ADRDA = Alzheimer9s Disease and Related Disorders Association; aMCI = amnestic mild cognitive impairment; ANOVA = analysis of variance; CDRSB = Clinical Dementia Rating Sum of Boxes; ERC = entorhinal cortex; FADRC-CC = Florida Alzheimer9s Disease Research Center–Clinical Core; HPC = hippocampus; HR = hazard ratio; MCI = mild cognitive impairment; MMSE = Mini-Mental State Examination; MTA = medial temporal lobe atrophy; MTL = medial temporal lobe; NACC = National Alzheimer9s Coordinating Center; naMCI = nonamnestic mild cognitive impairment; NCI = no cognitive impairment; NINCDS = National Institute of Neurological and Communicative Disorders and Stroke; NS = not significant; PRC = perirhinal cortex; VRS = visual rating system.

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  • Medial temporal lobe atrophy on MRI is considered an early and sensitive marker for AD, and is assumed to reflect underlying neuronal loss in hippocampus and temporal lobe.

    “Medial temporal lobe (MTA) atrophy as observed on MRI is considered to be an early and sensitive marker for AD, and is assumed that it reflects underlying neuronal loss in hippocampus and temporal lobe (Clerx et al., 2013; Jack et al., 1997; Duara et al., 2008).”

    From T1rho MRI and CSF biomarkers in diagnosis of Alzheimer's disease (2015) · cites this paper as Duara et al., 2008

    The Abstract reports that MRI-based MTA scores distinguish probable AD and amnestic MCI from comparison groups, with 85% sensitivity for probable AD at the reported cut score. The GLOSSARY discussion says MTA may serve as an early marker and correlates with medial temporal degenerative pathology at autopsy. It does not specifically identify neuronal loss in the hippocampus and temporal lobe as what the MRI finding reflects. Page numbers are not available for these passages. (LLM, conf=0.84)

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Authors
Duara, R., Loewenstein, D. A., Potter, E., Appel, J., Greig, M. T., Urs, R., Shen, Q., Raj, A., Small, B., Barker, W., Schofield, E., Wu, Y., & Potter, H.
Affiliations
University of Miami (US)
ORCID
Venue
Neurology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2008-12-09
Volume
71
Issue
24
Pages
1986-1992
ISSN
  • 0028-3878 (ISSN-L)
  • 1526-632X
DOI
10.1212/01.wnl.0000336925.79704.9f
PMC
PMC2676975
OpenAlex
W2004838625
Cited by
256
References
6
Citations by year
2026: 8 · 2025: 11 · 2024: 19 · 2023: 10 · 2022: 23 · 2021: 15 · 2020: 18 · 2019: 11 · 2018: 14 · 2017: 14 · 2016: 8 · 2015: 13 · 2014: 13 · 2013: 18 · 2012: 20
FWCI
9.60
Type
journal article
Language
en
Open access
Locations
  • Neurology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Aging (P50AG025711)
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 diagnosis, amnestic mild cognitive impairment, non-amnestic mild cognitive impairment, hippocampus, entorhinal cortex, perirhinal cortex, Clinical Dementia Rating, diagnostic criteria, MRI biomarkers, prodromal Alzheimer's disease, sensitivity and specificity
MeSH terms
Aged, Alzheimer Disease, Atrophy, Brain Mapping, Cognition Disorders, Diagnosis, Differential, Disability Evaluation, Female, Hippocampus, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Predictive Value of Tests, Severity of Illness Index, Temporal Lobe, Disease Progression, Parahippocampal Gyrus

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