Magnetic resonance imaging show­­ing parietal atrophy of the brain in late-onset Alzheimer’s dis­ease


Authors: D. Šilhán 1,2;  I. Ibrahim 3;  J. Tintěra 3;  A. Bartoš 1,2
Authors‘ workplace: Neurologická klinika 3. LF UK a FN Královské Vinohrady, Praha 1;  Národní ústav duševního zdraví, Klecany 2;  Institut klinické a experimentální medicíny, Praha 3
Published in: Cesk Slov Neurol N 2019; 82(1): 91-95
Category: Original Paper
doi: 10.14735/amcsnn201991

Overview

Aim:

Our intention was to as­sess whether a scor­­ing of parietal atrophy on MRI of the brain us­­ing a simple visual as­ses­sment named PAS (Parietal Atrophy Score) could be used in the dia­gnosis of late-onset Alzheimer‘s dis­ease.

Patients and methods:

The structure of the parietal lobes was evaluated by our visual scale named PAS, which is based on semiquantitative scor­­ing of atrophy of three structures in the parietal region: sulcus cingularis posterior, precuneus and parietal gyri. Parietal atrophy was as­ses­sed in 24 patients with late-onset Alzheimer‘s dis­ease in the stage of mild dementia (Mini-Mental State Examination; MMSE 21 ± 3 points) and 26 age-matched individuals with normal scores on the MMSE (29 ± 1 point).

Results:

We did not find any statistical­ly significant dif­ference in the size of any structure of the right and left parietal lobe accord­­ing to the PAS visual scale between control individuals and patients with Alzheimer‘s dis­ease (p > 0.05 in all cases).

Conclusion:

Dur­­ing late-onset Alzheimer‘s dis­ease there is no significant reduction of parietal cortex until the stage of mild dementia compared to normal aging. Parietal atrophy evaluated accord­­ing to the PAS visual scale is not an appropriate marker to be used in the dia­gnosis of late-onset Alzheimer‘s dis­ease in mild stages.

Key words:

Parietal Atrophy Score – parietal atrophy – magnetic resonance imaging – Alzheimer‘s disease – dementia – aging – sulcus cingularis posterior – precuneus – parietal gyri

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


磁共振成像显示晚发性阿尔茨海默氏症患者大脑顶叶萎缩

目的:

我们的目的是评估大脑MRI上的顶叶萎缩评分是否可以用于晚发性阿尔茨海默病的诊断。

患者和方法:

顶叶的结构是通过我们命名为PAS的视觉量表来评估的,它是基于对顶叶区域萎缩的三个结构的半定量评分:后扣带沟、楔前叶和顶叶回。对24例晚发阿尔茨海默氏症轻度痴呆(微精神状态检查;MMSE 21±3分),年龄匹配者26例,MMSE得分正常(29±1分)。

结果:

对照个体与阿尔茨海默病患者的PAS视觉量表比较,未发现左右顶叶结构大小差异有统计学意义(p > 0.05)。

结论:

在晚发性阿尔茨海默病中,直到轻度痴呆阶段,顶叶皮层与正常年龄相比没有明显的减少。根据PAS视觉量表评估的顶叶萎缩并不适合用于轻度迟发性阿尔茨海默病的诊断。

关键词:

顶叶萎缩评分-顶叶萎缩-磁共振成像-阿尔茨海默氏症-痴呆-衰老-颈沟后-楔前叶-顶叶回

 


Sources

1.    Bartoš A, Kukal J. Magnetická rezonance mozku u pa­cientů s Alzheimerovou chorobou. Psychiatrie 2005; 9 (Suppl 3): 39– 42.
2.    Harper L, Barkhof F, Scheltens P et al. An algorithmic approach to structural imag­­ing in dementia. J Neurol Neurosurg Psychiatry 2014; 85(6): 692– 698. doi: 10.1136/ jn­np-2013-306285.
3.    Scheltens P, Leys D, Barkhof F et al. Atrophy of medial temporal lobes on MRI in probable Alzheimers dis­ease and normal aging: dia­gnostic-value and neuropsychological cor­relates. J Neurol Neurosurg Psychiatry 1992; 55(10): 967– 972.
4.    Ten Kate M, Barkhof F, Boccardi M et al. Task Force for the Roadmap of Alzheimer’s Biomarkers. Clinical valid­ity of medial temporal atrophy as a bio­marker for Alzheimer’s dis­ease in the context of a structured 5-phase development framework. Neurobio­l Ag­­ing 2017; 52: 167– 182. doi: 10.1016/ j.neurobio­laging.2016.05.024.
5.    Bartoš A, Zach P, Diblíková F et al. Vizuální kategorizace mediotemporální atrofie na MR mozku u Alzheimerovy nemoci. Psychiatrie 2007; 11 (Suppl 3): 49– 52.
6.    Liu Y, Paajanen T, Zhang Y et al. Analysis of region­al MRI volumes and thicknes­ses as predictors of conversion from mild cognitive impairment to Alzheimer‘s dis­ease. Neurobio­l Ag­­ing 2010, 31(8): 1375– 1385. doi: 10.1016/ j.neurobio­laging.2010.01.022.
7.    Fen­nema-Notestine C, McEvoy LK, Hagler DJ et al. Structural neuroimag­­ing in the detection and prognosis of pre-clinical and early AD. Behav Neurol 2009; 21(1): 3– 12. doi: 10.3233/ BEN-2009-0230.
8.    Jack CR, Shiung MM, Gunter JL et al. Comparison of dif­ferent MRI brain atrophy rate measures with clinical dis­ease progres­sion in AD. Neurology 2004; 62(4): 591– 600. 
9.    Vemuri P, Jack CR. Role of structural MRI in Alzheimer’s dis­ease. Alzheimers Res Ther 2010; 2(4): 23. doi: 10.1186/ alzrt47.
10.    Pol LA, Hensel A, Flier WM et al. Hippocampal atrophy on MRI in frontotemporal lobar degeneration and Alzheimer‘s dis­ease. J Neurol Neurosurg Psychiatry 2006; 77(4): 439– 442. doi: 10.1136/ jn­np.2005.075341.
11.    Harper L, Fumagal­li GG, Barkhof F et al. MRI visual rat­­ing scales in the dia­gnosis of dementia: evaluation in 184 post-mortem confirmed cases. Brain 2016; 139(Pt 4): 1211– 1225. doi: 10.1093/ brain/ aww005.
12.    Hu WT, Wang Z, Lee VM et al. Distinct cerebral perfusion patterns in FTLD and AD. Neurology 2010, 75(10): 881– 888. doi: 10.1212/ WNL.0b013e3181f11e35.
13.    Landau SM, Harvey D, Madison CM et al. As­sociations between cognitive, functional, and FDG-PET measures of decline in AD and MCI. Neurobio­l Ag­­ing 2011; 32(7): 1207– 1218. doi: 10.1016/ j.neurobio­laging.2009.07.002.
14.    Lehmann M, Koedam EL, Barnes J et al. Posterior cerebral atrophy in the absence of medial temporal lobe atrophy in pathological­ly-confirmed Alzheimer’s dis­ease. Neurobio­l Ag­­ing 2012; 33(3): 627.e1– 627.e12. doi: 10.1016/ j.neurobio­laging.2011.04.003.
15.    Frisoni GB, Pievani M, Testa C et al. The topography of grey matter involvement in early and late onset Alzheimer‘s dis­ease. Brain 2007; 130(Pt 3): 720– 730. doi: 10.1093/ brain/ awl377.
16.    Ishii K, Kawachi T, Sasaki H et al. Voxel-based morphometric comparison between early- and late-onset mild Alzheimer‘s dis­ease and as­ses­sment of dia­gnostic performance of Z score images. Am J Neuroradiol 2005; 26(2): 333– 340.
17.    Shiino A, Watanabe T, Kitagawa T et al. Dif­ferent atrophic patterns in early- and late-onset Alzheimer‘s dis­ease and evaluation of clinical utility of a method of regional z-score analysis us­­ing voxel-based morphometry. Dement Geriatr Cogn Disord 2008; 26(2): 175– 186. doi: 10.1159/ 000151241.
18.    Šilhán D, Ibrahim I, Tintěra J et al. Parietální atrofický skór na magnetické rezonanci mozku u normálně stárnoucích osob. Cesk Slov Neurol N 2018; 81/ 114(4): 414– 419. doi: 10.14735/ amcsn­n2018414.
19.    McKhann GM, Knopman DS, Chertkow H et al. The dia­gnosis of dementia due to Alzheimer‘s dis­ease: recom­mendations from the National Institute on Aging-Alzheimer‘s As­sociation workgroups on dia­gnostic guide­lines for Alzheimer‘s dis­ease. Alzheimers Dement 2011; 7(3): 263– 269. doi: 10.1016/ j.jalz.2011.03.005.
20.    Bartoš A. Netestuj, ale POBAV: písemné záměrné Pojmenování OBrázků A jejich Vybavení jako krátká kognitivní zkouška. Cesk Slov Neurol N 2016; 79/ 112(6), 671– 679.
21.    Bartoš A. Test gest (TEGEST) k rychlému vyšetření epizodické paměti u mírné kognitivní poruchy. Cesk Slov Neurol N 2018; 81/ 114(1): 37– 44. doi: 10.14735/ amcsn­n201837.
22.    Bartoš A, Janoušek M, Petroušová R et al. Tři časy Testu kreslení hodin hodnocené BaJa skórováním u časné Alzheimerovy nemoci. Cesk Slov Neurol N 2016; 79/ 112(4): 406– 412.
23.    Bartoš A, Raisová M. Testy a dotazníky pro vyšetřování kognitivních funkcí, nálady a soběstačnosti. Praha: Mladá fronta 2015.
24.    Koedam EL, Lehman M, Van der Flier WM et al. Visual as­ses­sment of posterior atrophy development of a MRI rat­­ing scale. Eur Radiol 2011; 21(12): 2618– 2625. doi: 10.1007/ s00330-011-2205-4.

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Paediatric neurology Neurosurgery Neurology

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