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Differential cortical atrophy in subgroups of mild cognitive impairment

Sandra Bell-McGinty1, Oscar L Lopez, Carolyn Cidis Meltzer

  • 1Department of Psychiatry, University of Pittsburgh Medical Center, PA, USA.

Archives of Neurology
|September 15, 2005
PubMed
Abstract

Insights

Mild cognitive impairment (MCI) subtypes show distinct brain volume differences. MCI-amnestic patients exhibit mesial temporal lobe atrophy, while MCI-multiple cognitive domain patients show more widespread cortical loss, suggesting different dementia pathways.

Area of Science:

  • Neuroimaging
  • Neurology
  • Gerontology

Background:

  • Mild cognitive impairment (MCI) is a transitional stage between normal aging and dementia.
  • Subtyping MCI is crucial for understanding underlying pathologies and predicting progression.
  • Distinguishing between amnestic and multiple-domain MCI may reveal different neurodegenerative processes.

Purpose of the Study:

  • To compare gray matter brain volumes in subtypes of mild cognitive impairment (MCI) with elderly controls.
  • To investigate structural differences between MCI-amnestic (MCI-A) and MCI-multiple cognitive domain (MCI-MCD) patients.
  • To identify brain regions associated with MCI progression to Alzheimer's disease.

Main Methods:

  • Volumetric magnetic resonance imaging (MRI) was used for whole-brain voxel-based analysis.
  • Thirty-seven MCI patients (MCI-A, n=9; MCI-MCD, n=28) and 47 controls were studied.
  • Statistical Parametric Mapping (SPM99) software analyzed MRI scans.

Main Results:

  • MCI patients showed reduced hippocampal and middle temporal gyrus volumes compared to controls.
  • MCI-A patients had greater volume loss in the left entorhinal cortex and inferior parietal lobe than MCI-MCD patients.
  • MCI-MCD patients exhibited reduced volume in the right inferior frontal gyrus, right middle temporal gyrus, and bilateral superior temporal gyri compared to MCI-A patients.
  • Progression to Alzheimer's disease was associated with greater atrophy in specific cortical and mesial temporal regions.

Conclusions:

  • Distinct patterns of brain structural abnormalities exist in MCI subtypes.
  • MCI-A is characterized by mesial temporal and some neocortical loss, while MCI-MCD shows more diffuse neocortical involvement.
  • MCI heterogeneity may reflect different etiological pathways to dementia, potentially preceding Alzheimer's disease development.

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