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Medial temporal atrophy as a magnetic resonance imaging marker for Alzheimer's disease
L L Barclay1, C Linden, R Murtagh
1Department of Neurology, University of South Florida Health Sciences Center, Tampa 33612.
Abstract:
Medial temporal lobe atrophy (MTLA) on brain magnetic resonance imaging (MRI) may help differentiate Alzheimer's disease (AD) from multiinfarct dementia (MID) and other dementias. MTLA was seen in 6 of 11 patients with clinically diagnosed AD, 16 of 20 with mixed dementia (with both AD and MID), 1 of 5 with psychiatric disease, and in none of 32 with MID or 8 with other dementias (p less than 0.0001). Increased patchy periventricular signal, or "unidentified bright objects" were seen in 2 of 11 patients with AD, 10 of 20 patients with AD and MID, and 26 of 32 patients with MID. A larger series with autopsy correlation may verify that MTLA is a reasonably specific marker for AD, and unidentified bright objects are a sensitive, but not specific, marker for vascular dementias.
Insights
Medial temporal lobe atrophy (MTLA) on MRI scans may help distinguish Alzheimer's disease (AD) from other dementias. Unidentified bright objects are sensitive markers for vascular dementias but not specific.
Area of Science:
- Neurology
- Radiology
Background:
- Differentiating Alzheimer's disease (AD) from multiinfarct dementia (MID) and other dementias is clinically challenging.
- Brain magnetic resonance imaging (MRI) offers potential biomarkers for differential diagnosis.
Purpose of the Study:
- To investigate the utility of medial temporal lobe atrophy (MTLA) and unidentified bright objects (UBOs) on MRI in differentiating AD from MID and other dementias.
Main Methods:
- Retrospective analysis of MRI scans from patients with clinically diagnosed AD, mixed dementia (AD and MID), psychiatric disease, MID, and other dementias.
- Assessment for the presence and severity of MTLA and UBOs.
Main Results:
- MTLA was observed in 6/11 AD patients, 16/20 mixed dementia patients, 1/5 psychiatric disease patients, and 0/32 MID patients (p < 0.0001).
- UBOs were present in 2/11 AD patients, 10/20 mixed dementia patients, and 26/32 MID patients.
- MTLA showed higher specificity for AD, while UBOs were more sensitive for vascular dementias.
Conclusions:
- MTLA may serve as a specific MRI marker for Alzheimer's disease.
- UBOs are sensitive but not specific markers for vascular dementias, including multiinfarct dementia.