Structural Ultrasound of the Medial Temporal Lobe in Alzheimer's Disease.
PurposeOne of the anatomical hallmarks of Alzheimer's disease (AD) is the atrophy of the medial temporal lobe (MTL), yet cost-effective and broadly available methodological alternatives to the current imaging tools for screening of this brain area are not currently available.Materials and MethodsUsing structural transcranial ultrasound (TCS), we attempted to visualize and measure the MTL, and compared the results of 32 AD patients and 84 healthy controls (HC). The MTL and the surrounding space were defined in the coronal plane on TCS. A ratio of the height of the MTL/height of the choroidal fissure (M/F) was calculated in order to obtain a regional proportion.ResultsAn insufficient temporal bone window was identified in 22 % of the AD patients and 12 % of the HCs. The results showed that the ratio of M/F was significantly smaller in the AD group on both sides (p = 0.004 right, p = 0.007 left side). Furthermore, the M/F ratio made it possible to discriminate AD patients from HCs with a sensitivity of 83 % (right)/73 % (left) and a specificity of 76 % (right)/72 % (left) which is basically comparable to results published for magnetic resonance imaging. The measurements showed substantial intra/interrater reliability (ICC:0.79/0.69).ConclusionThese results suggest that utilization of structural TCS may possibly constitute a cheap and easy-to-use supplement to other techniques for the diagnosis of AD. It may be especially useful as a screening tool in the large population of individuals with cognitive decline. Further studies are needed to validate this novel method.
Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany.
Rezzak
R
Yilmaz
Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany.|Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Andrea
A
Pilotto
Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany.|Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany.
Benjamin
B
Roeben
Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany.|Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany.
Oliver
O
Preische
Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany.
Ulrike
U
Suenkel
Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany.
Sebastian
S
Heinzel
Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany.|Geriatric Center at the University Hospital, University of Tuebingen, Tuebingen, Germany.
Florian G
FG
Metzger
Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany.|Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany.|Geriatric Center at the University Hospital, University of Tuebingen, Tuebingen, Germany.|Section for Dementia Research, University of Tuebingen, Tuebingen, Germany.
Christoph
C
Laske
Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany.|Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany.
Walter
W
Maetzler
Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany.|Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany.|Department of Neurology, University Hospital Schleswig-Holstein (UKSH), Kiel, Germany.
Daniela
D
Berg
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging* / Q000191:economics; D001284:Atrophy; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D004453:Echoencephalography / Q000191:economics / Q000379:methods*; D005260:Female; D006624:Hippocampus / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics; D008875:Middle Aged; D009929:Organ Size / Q000502:physiology; D012016:Reference Values; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013702:Temporal Lobe / Q000000981:diagnostic imaging* / Q000473:pathology