Measuring brain atrophy in patients with mild cognitive impairment

Jun 16, 2009

Scientists at the University of California, San Diego School of Medicine have shown that a fully automated procedure called Volumetric MRI - which measures the "memory centers" of the brain and compares them to expected size - is effective in predicting the progression from mild cognitive impairment (MCI) to Alzheimer's disease. The procedure can be readily used in clinics to measure brain atrophy, and may help physicians to predict decline in MCI patients. Their study has been published in the June issue of the journal Alzheimer Disease and Associated Disorders.

"Use of this procedure is like bringing the experience of an expert neuro-radiologist to any clinic that has the right software," said James Brewer, MD, PhD, assistant professor in UC San Diego's Departments of Radiology and Neurosciences. "These fully automated and rapid methods of measuring medial volumes may help clinicians predict cognitive decline in their patients, and have the potential to influence how neurology is practiced."

Mild cognitive impairment (MCI) is considered a transitional stage between the forgetfulness associated with normal aging and Alzheimer's disease. Yet, many patients with MCI do not progress to Alzheimer's, and these individuals don't need treatments targeted to prevent or slow down neuro-degeneration. Therefore, objective measures are necessarily to distinguish MCI patients who will clinically decline from those who will remain stable.

"Our goal was to find neuroimaging measures of change that reflected more than merely a person's advancing age, but instead correlated tightly with how a person's cognitive status worsens over time," said co-author Michael Rafii, MD, PhD, assistant professor of neurosciences at UC San Diego. "It's too early to draw a definitive comparison, but it appears that these early changes - especially shrinking of the hippocampus - may offer a robust biological marker for change."

Medial temporal lobe atrophy has been associated with increased risk for conversion of MCI to Alzheimer's disease. However, until now, studies have focused only on measurements of the brain's hippocampus. The extent to which volumes of the amygdala - the section of the brain associated with emotions - and the nearby temporal horn could predict cognitive decline was unknown.

In addition, methods to measure these parts of the brain relied on subjective assessments of MRIs using a "tracing technique" that literally required a drawing of these portions of the brain - a technique that isn't practical or possible in most clinical settings.

For more than a year, researchers at the Memory Disorders Clinic at UC San Diego Medical Center have been successfully using a fully computerized procedure that takes images from the MRI scanner and translates them into quantitative values, according to Rafii, the clinic's director. UC San Diego was the first clinic site to use this technology, which is now starting to be used in other clinical settings throughout the country.

The study looked at the fully automated volume measures of 269 MCI patients over a six-month interval. Baseline volume measurements of the hippocampus, amygdala and temporal horn were evaluated as predictors of cognitive change as measured by two commonly used instruments for screening cognitive function and dementia. Patients with smaller volumes of the hippocampus and amygdala showed more rapid clinical decline on these tests.

"These values objectively measure the hippocampus and amydala, and early data confirm previous findings that these brain areas may atrophy early in Alzheimer's disease and can offer a clinical marker for change," said Rafii. The fluid-filled temporal horn increases as the hippocampus shrinks, and these complementary measurements may correlate closely with how a patient's cognitive status worsens over time, he added.

Source: University of California - San Diego (news : web)

Explore further: Ebola reveals shortcomings of African solidarity

add to favorites email to friend print save as pdf

Related Stories

MRI shows brain atrophy pattern that predicts Alzheimer's

Feb 10, 2009

Using special MRI methods, researchers have identified a pattern of regional brain atrophy in patients with mild cognitive impairment (MCI) that indicates a greater likelihood of progression to Alzheimer's disease. The findings ...

Recommended for you

Ebola reveals shortcomings of African solidarity

4 hours ago

As Africa's leaders meet in Ethiopia to discuss the Ebola crisis, expectations of firm action will be tempered by criticism over the continent's poor record in the early stages of the epidemic.

Second bird flu case confirmed in Canada

20 hours ago

The husband of a Canadian who was diagnosed earlier this week with bird flu after returning from a trip to China has also tested positive for the virus, health officials said Friday.

What exactly is coronavirus?

Jan 30, 2015

The conflicts in Syria and Iraq are straining public health systems and public health efforts meant to prevent and detect the spread of infectious diseases. This is generating a "perfect storm" of conditions for outbreaks. Among the infections raising concern is Middle East Respiratory Syndrome, caused by a type of coronavirus, which emerged in 2012. ...

Scientists find Ebola virus is mutating

Jan 30, 2015

(Medical Xpress)—Researchers working at Institut Pasteur in France have found that the Ebola virus is mutating "a lot" causing concern in the African countries where the virus has killed over eight thous ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.