title: Posterior Atrophy and Medial Temporal Atrophy Scores Are Associated with Different Symptoms in Patients with Alzheimer's Disease and Mild Cognitive Impairment.
abstract: BACKGROUND
  Whether the occurrence of posterior atrophy (PA) and medial temporal lobe atrophy (MTA) was correlated with cognitive and non-cognitive symptoms in Alzheimer's disease (AD) and mild cognitive impairment (MCI) patients are unclear.
  
  
  METHODS
  Patients with probable AD and MCI from a medical center outpatient clinic received attention, memory, language, executive function evaluation and Mini-Mental Status Examination (MMSE). The severity of dementia was rated by the Clinical Dementia Rating (CDR) Sum of Box (CDR-SB). The neuropsychiatric inventory (NPI) subscale of agitation/aggression and mood symptoms was also applied. Magnetic resonance imaging (MRI) was scored visually for the MTA, PA and white matter hyperintensity (WMH) scores.
  
  
  RESULTS
  We recruited 129 AD and 31 MCI (mean age 78.8 years, 48% female) patients. MMSE scores, memory, language and executive function were all significantly decreased in individuals with AD than those with MCI (p < 0.01). MTA and PA scores reflected significant atrophy in AD compared to MCI; however, the WMH scores did not differ. The MTA scores were significantly correlated with the frontal, parieto-occipital and global WMH scores (p < 0.01) while the PA scores showed a correlation with the parieto-occipital and temporal WMH scores (p < 0.01). After adjusting for age, education, APOE4 gene and diagnostic group covariates, the MTA scores showed a significant association with MMSE and CDR-SB, while the right side PA scores were significantly associated with NPI-agitation/aggression subscales (p < 0.01).
  
  
  CONCLUSIONS
  Regional atrophy is related to different symptoms in patients with AD or MCI. PA score is useful as a complementary measure for non-cognitive symptom.
authors.affiliation: Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan; Section of Dementia and Cognitive Impairment, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan; Brain and Consciousness Research Center, Taipei Medical University, Shuang Ho Hospital, New Taipei City, Taiwan.
authors.forename: Jung-Lung
authors.initials: JL
authors.lastname: Hsu
authors.affiliation: Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan; Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan.
authors.forename: Wei-Ju
authors.initials: WJ
authors.lastname: Lee
authors.affiliation: Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan; Brain Research Center, National Yang-Ming University Schools of Medicine, Taipei, Taiwan; Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Yi-Chu
authors.initials: YC
authors.lastname: Liao
authors.affiliation: Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Jiing-Feng
authors.initials: JF
authors.lastname: Lirng
authors.affiliation: Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University Schools of Medicine, Taipei, Taiwan; Brain Research Center, National Yang-Ming University Schools of Medicine, Taipei, Taiwan; Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Shuu-Jiun
authors.initials: SJ
authors.lastname: Wang
authors.affiliation: Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan; Brain Research Center, National Yang-Ming University Schools of Medicine, Taipei, Taiwan; Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Jong-Ling
authors.initials: JL
authors.lastname: Fuh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000473:pathology*; D001284:Atrophy; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D013702:Temporal Lobe / Q000473:pathology*