title: Comparisons between global and focal brain atrophy rates in normal aging and Alzheimer disease: Boundary Shift Integral versus tracing of the entorhinal cortex and hippocampus.
abstract: The objectives of this study were to (1) compare atrophy rates associated with normal aging and Alzheimer disease (AD) using the semi-automated Boundary Shift Integral (BSI) method and manual tracing of the entorhinal cortex (ERC) and hippocampus and (2) calculate power of BSI vs. ERC and hippocampal volume changes for clinical trials in AD. We quantified whole brain and ventricular BSI atrophy rates and ERC and hippocampal atrophy rates from longitudinal MRI data in 20 AD patients and 22 age-matched healthy controls. All methods revealed significant brain atrophy in controls and AD patients. AD patients had approximately 2.5 times greater whole brain BSI atrophy rates and more than 5 times greater ERC and hippocampal atrophy rates than controls. ERC and hippocampal atrophy rates were higher in both groups than whole brain BSI atrophy rates, but lower than ventricular BSI atrophy rates. Effect size and power calculations suggest that ERC and hippocampal measurements may be more sensitive than ventricular or whole brain BSI for detecting AD progression and the potential effects of disease modifying agents. Logistic regression analysis revealed that combined rates of ERC and ventricular BSI were the best explanatory variables for classifying AD from controls.
authors.affiliation: Magnetic Resonance Unit, San Francisco Veterans Affairs Medical Center, San Francisco, California 94121, USA.
authors.forename: Frank
authors.initials: F
authors.lastname: Ezekiel
authors.forename: Linda
authors.initials: L
authors.lastname: Chao
authors.forename: John
authors.initials: J
authors.lastname: Kornak
authors.forename: An-Tao
authors.initials: AT
authors.lastname: Du
authors.forename: Valerie
authors.initials: V
authors.lastname: Cardenas
authors.forename: Diana
authors.initials: D
authors.lastname: Truran
authors.forename: William
authors.initials: W
authors.lastname: Jagust
authors.forename: Helena
authors.initials: H
authors.lastname: Chui
authors.forename: Bruce
authors.initials: B
authors.lastname: Miller
authors.forename: Kristine
authors.initials: K
authors.lastname: Yaffe
authors.forename: Norbert
authors.initials: N
authors.lastname: Schuff
authors.forename: Michael
authors.initials: M
authors.lastname: Weiner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000473:pathology; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D002552:Cerebral Ventricles / Q000473:pathology; D018450:Disease Progression; D018728:Entorhinal Cortex / Q000473:pathology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male