title: Cerebral volume loss, cognitive deficit and neuropsychological performance: comparative measures of brain atrophy: I. Dementia.
abstract: There are several magnetic resonance (MR) imaging methods to measure brain volume and cerebral atrophy; however, the best measure for examining potential relationships between such measures and neuropsychological performance has not been established. Relationships between seven measures of MR derived brain volume or indices of atrophy and neuropsychological performance in the elderly subjects of the population-based Cache County, Utah Study of Aging and Memory (n = 195) were evaluated. The seven MR measures included uncorrected total brain volume (TBV), TBV corrected by total intracranial volume (TICV), TBV corrected by the ratio of the individuals TICV by group TICV (TBVC), a ventricle-to-brain ratio (VBR), total ventricular volume (TVV), TVV corrected by TICV, and a measure of parenchymal volume loss. The cases from the Cache County Study were comprised of elderly individuals classified into one of four subject groups based on a consensus diagnostic process, independent of quantitative MR imaging findings. The groups included subjects with Alzheimer's disease (AD, n = 85), no dementia but mild/ambiguous (M/A) deficits (n = 30), a group of subjects with non-AD dementia or neuropsychiatric disorder including vascular dementia (n = 60), and control subjects (n = 20). Neuropsychological performance was based on the Mini-Mental Status Exam (MMSE) and an expanded neuropsychological test battery (consortium to establish a registry for Alzheimer's disease (CERAD). The results demonstrated that the various quantitative MR measures were highly interrelated and no single measure was statistically superior. However, TBVC, TBV/TICV and VBR consistently exhibited the more robust relationships with neuropsychological performance. These results suggest that a single corrected brain volume measure or index is sufficient in studies examining global MR indicators of cerebral atrophy in relation to cognitive function and recommends use of either TBVC, TBV/TICV, or VBR.
authors.affiliation: Department of Psychiatry and Neuroscience, Brigham Young University, Provo, Utah 84602, USA. erin_bigler@byu.edu
authors.forename: Erin D
authors.initials: ED
authors.lastname: Bigler
authors.forename: E Shannon
authors.initials: ES
authors.lastname: Neeley
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Miller
authors.forename: David F
authors.initials: DF
authors.lastname: Tate
authors.forename: Sara A
authors.initials: SA
authors.lastname: Rice
authors.forename: Howard
authors.initials: H
authors.lastname: Cleavinger
authors.forename: Lara
authors.initials: L
authors.lastname: Wolfson
authors.forename: Joann
authors.initials: J
authors.lastname: Tschanz
authors.forename: Kathleen
authors.initials: K
authors.lastname: Welsh-Bohmer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology / Q000503:physiopathology; D001284:Atrophy / Q000209:etiology; D002540:Cerebral Cortex / Q000473:pathology*; D002552:Cerebral Ventricles / Q000473:pathology / Q000503:physiopathology; D003072:Cognition Disorders / Q000209:etiology*; D003704:Dementia / Q000150:complications*; D005260:Female; D006257:Head / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests / Q000706:statistics & numerical data