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Updated: May 7, 2026
A Comprehensive Protocol for Manual Segmentation of the Medial Temporal Lobe Structures
Published on: July 2, 2014
Usefulness of medial temporal lobe atrophy visual rating scale in detecting Alzheimer's disease: Preliminary study
Jae-Hyeok Heo1, Min-Ky Kim, Jun-Hyung Lee
1Department of Neurology, Seoul Medical Center 156, Shinnae-dong, Chungrang-gu, Seoul, Korea.
Background:
The Korean version of Mini-Mental Status Examination (K-MMSE) and the Korean version of Addenbrooke Cognitive Examination (K-ACE) have been validated as quick neuropsychological tests for screening dementia in various clinical settings. Medial temporal atrophy (MTA) is an early pathological characteristic of Alzheimer's disease (AD). We aimed to assess the diagnostic validity of the fusion of the neuropsychological test and visual rating scale (VRS) of MTA in AD.
Materials And Methods:
A total of fifty subjects (25 AD, 25 controls) were included. The neuropsychological tests used were the K-MMSE and the K-ACE. T1 axial imaging visual rating scale (VRS) was applied for assessing the grade of MTA. We calculated the fusion score with the difference of neuropsychological test and VRS of MTA. The receiver operating characteristics (ROC) curve was used to determine optimal cut-off score, sensitivity and specificity of the fusion scores in screening AD.
Results:
No significant differences in age, gender and education were found between AD and control group. The values of K-MMSE, K-ACE, CDR, VRS and cognitive function test minus VRS were significantly lower in the AD group than control group. The AUC (Area under the curve), sensitivity and specificity for K-MMSE minus VRS were 0.857, 84% and 80% and for K-ACE minus VRS were 0.884, 80% and 88%, respectively. Those for K-MMSE only were 0.842, 76% and 72% and for K-ACE only were 0.868, 80% and 88%, respectively.
Conclusions:
The fusion of the neuropsychological test and VRS suggested clinical usefulness in their easy and superiority over neuropsychological test only. However, this study failed to find any difference. This may be because of small numbers in the study or because there is no true difference.
Insights
Combining cognitive tests with medial temporal atrophy (MTA) visual rating scales (VRS) may improve Alzheimer's disease (AD) screening. While the fused scores showed high accuracy, this study found no significant difference compared to cognitive tests alone, possibly due to small sample size.
Area of Science:
- Neurology
- Neuroimaging
- Cognitive Science
Background:
- Korean versions of Mini-Mental Status Examination (K-MMSE) and Addenbrooke Cognitive Examination (K-ACE) are validated dementia screening tools.
- Medial temporal atrophy (MTA) is an early indicator of Alzheimer's disease (AD) pathology.
Purpose of the Study:
- To evaluate the diagnostic validity of combining neuropsychological tests (K-MMSE, K-ACE) with a visual rating scale (VRS) for MTA in AD screening.
- To assess if this fusion approach improves upon using cognitive tests alone.
Main Methods:
- Fifty subjects (25 AD, 25 controls) underwent K-MMSE and K-ACE.
- T1 axial imaging was used for VRS assessment of MTA.
- Fusion scores were calculated by subtracting VRS from cognitive test scores.
- Receiver operating characteristic (ROC) curves analyzed diagnostic performance.
Main Results:
- K-MMSE, K-ACE, and VRS scores were significantly lower in the AD group.
- Fusion of K-ACE with VRS showed high diagnostic accuracy (AUC 0.884, sensitivity 80%, specificity 88%).
- Fusion scores demonstrated comparable or superior sensitivity and specificity compared to individual cognitive tests.
Conclusions:
- The fusion of K-ACE and MTA VRS shows potential clinical utility for AD screening.
- While promising, the study did not find a statistically significant superiority over cognitive tests alone, possibly due to sample size limitations.
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