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Brain atrophy rates predict subsequent clinical conversion in normal elderly and amnestic MCI
C R Jack1, M M Shiung, S D Weigand
1Department of Diagnostic Radiology, Mayo Clinic and Foundation, Rochester, MN 55905, USA. jack.clifford@mayo.edu
Neurology
|October 26, 2005
Summary
Brain atrophy rates, particularly in the ventricles and whole brain, predict clinical decline in healthy elderly and mild cognitive impairment (MCI) patients. Serial MRI scans offer valuable prognostic information for Alzheimer's disease progression.
Area of Science:
- Neurology
- Radiology
- Geriatrics
Background:
- Mild cognitive impairment (MCI) is a transitional stage between normal aging and Alzheimer's disease (AD).
- Early detection and prediction of conversion to AD are crucial for timely intervention.
- Serial magnetic resonance imaging (MRI) can detect brain structural changes over time.
Purpose of the Study:
- To assess if atrophy rates from serial MRI predict clinical progression in cognitively healthy elderly and amnestic MCI subjects.
- To determine the association between brain structure atrophy rates and time to clinical conversion.
Main Methods:
- Ninety-one healthy elderly and 72 amnestic MCI subjects were analyzed.
- Atrophy rates of hippocampus, entorhinal cortex, whole brain, and ventricles were measured from MRI scans taken 1-2 years apart.
- Clinical conversion was monitored from the time of the second MRI scan.
Main Results:
- In healthy subjects, increased ventricular atrophy predicted conversion.
- In MCI subjects, increased ventricular and whole brain atrophy predicted conversion to AD.
- Both ventricular and whole brain atrophy rates provided predictive information beyond baseline hippocampal volume for MCI to AD conversion.
Conclusions:
- Accelerated whole brain and ventricular atrophy rates predict increased risk of clinical decline.
- Combining baseline hippocampal volume with serial MRI atrophy rates enhances prediction of MCI to AD conversion.
- These MRI-based measures offer valuable prognostic insights but may not provide absolute individual patient predictions.
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