title: Morphologic and neuropsychological patterns in patients suffering from Alzheimer's disease.
abstract: BACKGROUND
  We conducted a retrospective study to identify morphological subgroups of patients referred for AD or aMCI and to seek for differences across neuropsychological performances.
  
  
  METHODS
  One hundred forty-five patients (mean age = 76.01, 88 women and 57 men) referred for AD, either at the stage of dementia or aMCI, were examined using structural MRI. Five observers reviewed blindly twice all examinations. We rated microangiopathy, hippocampal, parietal atrophies, including a gradient of fronto-parietal atrophy (GFPA). A multiple component analysis (MCA) followed by a hierarchical ascending classification was conducted to identify morphologically distinct subgroups. Among these, 76 patients completed all the neuropsychological tests. Univariate and multivariate analyses were further conducted on these data across morphological subgroups. The institutional review board approved the research protocol.
  
  
  RESULTS
  Inter- and intra-raters' agreements were excellent and very good for microangiopathy and hippocampal atrophy ratings. They were higher for GFPA than for the parietal atrophy scale. MCA without priors identified three groups: group 1 was characterized by no/discrete microangiopathy, severe hippocampal, and predominant parietal atrophy; group 2 had significant microangiopathy, severe hippocampal atrophy, and no predominant parietal atrophy; group 3 had a mild hippocampal atrophy and parietal atrophies. In group 1, working memory profile was less impaired than in group 2 (p = 0.01). Neuropsychological performances of group 3 were higher in most domains.
  
  
  CONCLUSIONS
  Combined characterization of microangiopathy, hippocampal, parietal, and GFPA allows identifying morphological subgroups among patients referred for AD and at risk. These groups have some neuropsychological differences, suggesting different pathophysiological mechanisms or co-existing conditions.
authors.affiliation: Department of Neuroradiology and MRI, University Hospital of Grenoble, CS 10217, 38043 cedex 9, Grenoble, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Chapuis
authors.affiliation: Department of Neurology, University Hospital of Grenoble, Grenoble, France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Sauvée
authors.affiliation: CIT803, University Hospital of Grenoble, Grenoble, France.
authors.forename: Maud
authors.initials: M
authors.lastname: Medici
authors.affiliation: Department of Neurology, University Hospital of Grenoble, Grenoble, France.
authors.forename: Amélie
authors.initials: A
authors.lastname: Serra
authors.affiliation: Department of Neuroradiology and MRI, University Hospital of Grenoble, CS 10217, 38043 cedex 9, Grenoble, France.
authors.forename: Eldda
authors.initials: E
authors.lastname: Banciu
authors.affiliation: CIT803, University Hospital of Grenoble, Grenoble, France.|Joseph Fourier University, Grenoble, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Moreau-Gaudry
authors.affiliation: Department of Neurology, University Hospital of Grenoble, Grenoble, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Moreaud
authors.affiliation: Department of Neuroradiology and MRI, University Hospital of Grenoble, CS 10217, 38043 cedex 9, Grenoble, France. akrainik@chu-grenoble.fr.|INSERM U 836, Grenoble Institute of Neurosciences, Grenoble, France. akrainik@chu-grenoble.fr.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Krainik
mesh_terms: D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic
keywords: Alzheimer dementia; Lobar atrophy of brain; Magnetic resonance imaging; Neuropsychology; White matter