title: An MRI brain atrophy and lesion index to assess the progression of structural changes in Alzheimer's disease, mild cognitive impairment, and normal aging: a follow-up study.
abstract: BACKGROUND
  A brain atrophy and lesion index (BALI) based on high-field magnetic resonance imaging (MRI) has recently been validated to evaluate structural changes in the aging brain. The present study investigated the two-year progression of brain structural deficits in people with Alzheimer's disease (AD) and mild cognitive impairment (MCI), and in healthy control older adults (HC) using the BALI rating.
  
  
  METHODS
  T1-weighted high-resolution anatomical imaging data using 3 Tesla MRI at baseline (AD = 39, MCI = 82, HC = 58) and at 24-months were obtained from the Alzheimer's disease Neuroimaging Initiative database. Lesions in various brain structures, including the infratentorial and basal ganglia areas, and the periventricular and deep white matter and global atrophy, were evaluated and combined into the BALI scale.
  
  
  RESULTS
  Mean progression of brain deficits over two years was evident in all diagnostic groups (p < 0.001) and was statistically greater in MCI-AD converters than in the non-converters (p = 0.044). An increase in the BALI score was significantly associated with cognitive test scores (p = 0.008 for the Mini-Mental State Examination MMSE and p = 0.013 for the Alzheimer's Disease Assessment Scale-Cognitive Subscale ADAS-cog) in a model that adjusted for age, sex, and education.
  
  
  CONCLUSIONS
  The BALI rating quantified the progression of brain deficits over two years, which is associated with cognitive decline. BALI ratings may be used to help summarize AD-associated structural variations.
authors.affiliation: National Research Council Canada Institute for Biodiagnostics (Atlantic), Halifax, NS, Canada.
authors.forename: Ningnannan
authors.initials: N
authors.lastname: Zhang
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Song
authors.forename: Yunting
authors.initials: Y
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Ryan C N
authors.initials: RC
authors.lastname: D'Arcy
authors.forename: Sultan
authors.initials: S
authors.lastname: Darvesh
authors.forename: John D
authors.initials: JD
authors.lastname: Fisk
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rockwood
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000544:Alzheimer Disease / Q000473:pathology*; D001284:Atrophy / Q000473:pathology; D001921:Brain / Q000473:pathology*; D016009:Chi-Square Distribution; D060825:Cognitive Dysfunction / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged