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Distinct Patterns of Brain Atrophy in Amnestic Mild Cognitive Impairment and Motoric Cognitive Risk Syndromes
Vineela Nagamalla1, Joe Verghese1,2, Emmeline Ayers2
1Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
Introduction:
Motoric cognitive risk (MCR) and amnestic mild cognitive impairment (aMCI) syndromes are each reliable predictors of incident Alzheimer's disease (AD), but MCR may be a stronger predictor of vascular dementia than AD. This study contrasted cortical and hippocampal atrophy patterns in MCR and aMCI.
Methods:
Cross-sectional data from 733 older adults without dementia or disability (M age = 73.6; 45% women) in the multicountry MCR consortium were examined. MCR was defined as presence of slow gait and cognitive concerns. Amnestic MCI was defined as poor episodic memory performance and cognitive concerns. Cortical thickness and hippocampal volumes were quantified from structural MRIs. Multivariate and univariate general linear models were used to examine associations between cortical thickness and hippocampal volume in MCR and aMCI, adjusting for age, sex, education, total intracranial volume, white matter lesions, and study site.
Results:
The prevalence of MCR and aMCI was 7.64% and 12.96%, respectively. MCR was associated with widespread cortical atrophy, including prefrontal, insular, cingulate, motor, parietal, and temporal atrophy. aMCI was associated with hippocampal atrophy.
Conclusion:
Distinct patterns of atrophy were associated with MCR and aMCI. A distributed pattern of cortical atrophy - that is more consistent with VaD or mixed dementia- was observed in MCR. A more restricted pattern of atrophy - that is more consistent with AD - was observed in aMCI. The biological underpinnings of MCR and aMCI likely differ and may require tailored interventions.
Introduction:
Motoric cognitive risk (MCR) and amnestic mild cognitive impairment (aMCI) syndromes are each reliable predictors of incident Alzheimer's disease (AD), but MCR may be a stronger predictor of vascular dementia than AD. This study contrasted cortical and hippocampal atrophy patterns in MCR and aMCI.
Methods:
Cross-sectional data from 733 older adults without dementia or disability (M age = 73.6; 45% women) in the multicountry MCR consortium were examined. MCR was defined as presence of slow gait and cognitive concerns. Amnestic MCI was defined as poor episodic memory performance and cognitive concerns. Cortical thickness and hippocampal volumes were quantified from structural MRIs. Multivariate and univariate general linear models were used to examine associations between cortical thickness and hippocampal volume in MCR and aMCI, adjusting for age, sex, education, total intracranial volume, white matter lesions, and study site.
Results:
The prevalence of MCR and aMCI was 7.64% and 12.96%, respectively. MCR was associated with widespread cortical atrophy, including prefrontal, insular, cingulate, motor, parietal, and temporal atrophy. aMCI was associated with hippocampal atrophy.
Conclusion:
Distinct patterns of atrophy were associated with MCR and aMCI. A distributed pattern of cortical atrophy - that is more consistent with VaD or mixed dementia- was observed in MCR. A more restricted pattern of atrophy - that is more consistent with AD - was observed in aMCI. The biological underpinnings of MCR and aMCI likely differ and may require tailored interventions.
Insights
Motoric cognitive risk (MCR) is linked to widespread brain atrophy, suggesting vascular dementia, while amnestic mild cognitive impairment (aMCI) shows hippocampal atrophy, indicating Alzheimer's disease. These distinct patterns suggest different underlying causes.
Area of Science:
- Neurology
- Neuroimaging
- Geriatrics
Background:
- Motoric cognitive risk (MCR) and amnestic mild cognitive impairment (aMCI) predict dementia.
- MCR may predict vascular dementia more than Alzheimer's disease (AD).
- This study investigated differing atrophy patterns in MCR and aMCI.
Purpose of the Study:
- To contrast cortical and hippocampal atrophy patterns in MCR and aMCI syndromes.
- To differentiate the neurobiological underpinnings of MCR and aMCI.
Main Methods:
- Analysis of cross-sectional data from 733 older adults without dementia.
- MCR defined by slow gait and cognitive concerns; aMCI by poor episodic memory and cognitive concerns.
- Structural MRI used to quantify cortical thickness and hippocampal volumes, with statistical modeling.
Main Results:
- MCR associated with widespread cortical atrophy (prefrontal, insular, cingulate, motor, parietal, temporal).
- aMCI associated with hippocampal atrophy.
- Prevalence of MCR was 7.64%; aMCI was 12.96%.
Conclusions:
- Distinct atrophy patterns observed in MCR and aMCI.
- MCR's distributed cortical atrophy aligns with vascular or mixed dementia.
- aMCI's restricted atrophy aligns with AD, suggesting different biological bases and need for tailored interventions.
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