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Prediction of AD with MRI-based hippocampal volume in mild cognitive impairment
C R Jack1, R C Petersen, Y C Xu
1Department of Diagnostic Radiology, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
Objective:
To test the hypothesis that MRI-based measurements of hippocampal volume are related to the risk of future conversion to Alzheimer's disease (AD) in older patients with a mild cognitive impairment (MCI).
Background:
Patients who develop AD pass through a transitional state, which can be characterized as MCI. In some patients, however, MCI is a more benign condition, which may not progress to AD or may do so slowly.
Patients:
Eighty consecutive patients who met criteria for the diagnosis of MCI were recruited from the Mayo Clinic Alzheimer's Disease Center/Alzheimer's Disease Patient Registry.
Methods:
At entry into the study, each patient received an MRI examination of the head, from which the volumes of both hippocampi were measured. Patients were followed longitudinally with approximately annual clinical/cognitive assessments. The primary endpoint was the crossover of individual MCI patients to the clinical diagnosis of AD during longitudinal clinical follow-up.
Results:
During the period of longitudinal observation, which averaged 32.6 months, 27 of the 80 MCI patients became demented. Hippocampal atrophy at baseline was associated with crossover from MCI to AD (relative risk [RR], 0.69, p = 0.015). When hippocampal volume was entered into bivariate models-using age, postmenopausal estrogen replacement, standard neuropsychological tests, apolipoprotein E (APOE) genotype, history of ischemic heart disease, and hypertension-the RRs were not substantially different from that found univariately, and the associations between hippocampal volume and crossover remained significant.
Conclusion:
In older patients with MCI, hippocampal atrophy determined by premorbid MRI-based volume measurements is predictive of subsequent conversion to AD.
Insights
MRI-measured hippocampal volume predicts Alzheimer's disease (AD) conversion in mild cognitive impairment (MCI) patients. Reduced hippocampal volume in MCI individuals indicates a higher risk of progressing to AD.
Area of Science:
- Neurology
- Neuroimaging
- Geriatrics
Background:
- Alzheimer's disease (AD) progression involves a mild cognitive impairment (MCI) stage.
- MCI can be a transitional phase or a benign condition.
- Predicting AD conversion in MCI patients is crucial for early intervention.
Purpose of the Study:
- To investigate the relationship between MRI-derived hippocampal volume and future Alzheimer's disease (AD) conversion risk.
- To assess if hippocampal volume measurements can predict the progression from mild cognitive impairment (MCI) to AD.
Main Methods:
- Recruited 80 MCI patients from the Mayo Clinic Alzheimer's Disease Center.
- Conducted baseline MRI to measure hippocampal volumes.
- Followed patients longitudinally with clinical/cognitive assessments to determine AD conversion.
Main Results:
- 27 out of 80 MCI patients converted to AD over an average follow-up of 32.6 months.
- Baseline hippocampal atrophy was significantly associated with conversion from MCI to AD (RR=0.69, p=0.015).
- This association remained significant even after adjusting for other risk factors like age and APOE genotype.
Conclusions:
- Premorbid MRI-based hippocampal volume measurements predict subsequent conversion to Alzheimer's disease (AD) in older MCI patients.
- Hippocampal atrophy is a significant early indicator of AD progression in individuals with MCI.