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Visual assessment of posterior atrophy development of a MRI rating scale
Esther L G E Koedam1, Manja Lehmann, Wiesje M van der Flier
1Department of Neurology and Alzheimer Centre, VU University Medical Centre, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. elge.koedam@vumc.nl
Objective:
To develop a visual rating scale for posterior atrophy (PA) assessment and to analyse whether this scale aids in the discrimination between Alzheimer's disease (AD) and other dementias.
Methods:
Magnetic resonance imaging of 118 memory clinic patients were analysed for PA (range 0-3), medial temporal lobe atrophy (MTA) (range 0-4) and global cortical atrophy (range 0-3) by different raters. Weighted-kappas were calculated for inter- and intra-rater agreement. Relationships between PA and MTA with the MMSE and age were estimated with linear-regression analysis.
Results:
Intra-rater agreement ranged between 0.93 and 0.95 and inter-rater agreement between 0.65 and 0.84. Mean PA scores were higher in AD compared to controls (1.6 ± 0.9 and 0.6 ± 0.7, p < 0.01), and other dementias (0.8 ± 0.8, p < 0.01). PA was not associated with age compared to MTA (B = 1.1 (0.8) versus B = 3.1 (0.7), p < 0.01)). PA and MTA were independently negatively associated with the MMSE (B = -1.6 (0.5), p < 0.01 versus B = -1.4 (0.5), p < 0.01).
Conclusion:
This robust and reproducible scale for PA assessment conveys independent information in a clinical setting and may be useful in the discrimination of AD from other dementias.
Insights
A new visual rating scale for posterior atrophy (PA) effectively differentiates Alzheimer's disease (AD) from other dementias. This reproducible scale shows higher PA scores in AD patients, aiding clinical diagnosis.
Area of Science:
- Neurology
- Radiology
- Gerontology
Background:
- Alzheimer's disease (AD) diagnosis relies on clinical assessment and neuroimaging.
- Posterior atrophy (PA) is a recognized neuroimaging biomarker in AD.
- Standardized assessment of PA is crucial for accurate diagnosis and research.
Purpose of the Study:
- To develop and validate a visual rating scale for assessing posterior atrophy (PA).
- To determine if the developed PA scale can differentiate Alzheimer's disease (AD) from other forms of dementia.
Main Methods:
- Magnetic resonance imaging (MRI) scans of 118 memory clinic patients were analyzed.
- A visual rating scale was developed for PA, medial temporal lobe atrophy (MTA), and global cortical atrophy.
- Inter- and intra-rater reliability was assessed using weighted-kappas.
- Linear regression analysis explored relationships between PA, MTA, age, and Mini-Mental State Examination (MMSE) scores.
Main Results:
- The PA scale demonstrated robust intra-rater (0.93-0.95) and good inter-rater (0.65-0.84) agreement.
- Mean PA scores were significantly higher in AD patients compared to controls and other dementias (p < 0.01).
- PA was not associated with age, unlike MTA, but both PA and MTA were independently and negatively associated with MMSE scores (p < 0.01).
Conclusions:
- The developed visual rating scale for PA is robust, reproducible, and reliable.
- This PA assessment scale provides independent information valuable in clinical settings.
- The PA scale shows potential utility in discriminating Alzheimer's disease from other dementias.
