title: Anatomic Correlation of the Mini-Mental State Examination: A Voxel-Based Morphometric Study in Older Adults.
abstract: The clinical utility of the Mini-Mental State Examination (MMSE) and its shorter version (SMMSE) is still debated. There is a need to better understand the neuroanatomical correlates of these cognitive tests. The objective of this cross-sectional study was to determine whether lower MMSE and SMMSE scores correlated with focal brain volume reduction in older adults. Participants from the GAIT study (n = 207; mean, 70.9±5.9 years; 57% female; mean MMSE 26.2±3.9; mean SMMSE 5.1±1.1) were evaluated using the MMSE and SMMSE and received a 1.5-Tesla MRI scan of the brain. Cortical gray and white matter subvolumes were automatically segmented using Statistical Parametric Mapping. Age, gender, education level, and total intracranial volume were included as potential confounders. We found correlations between the MMSE score and specific cortical regions of the limbic system including the hippocampus, amygdala, cingulate gyrus, and parahippocampal gyrus, independently of the diagnostic category (i.e., mild cognitive impairment or Alzheimer disease or controls). Regarding correlations with the SMMSE score, only one cluster in the left hippocampus was identified, which overlapped with the cluster that was positively correlated with the MMSE score. There were no correlations with the volume of white matter. In conclusion, worse MMSE and SMMSE scores were associated with gray matter atrophy mainly in the limbic system. This finding highlights that atrophy of specific brain regions are related to performance on the MMSE and the SMMSE tests, and provides new insights into the cognitive function probed by these tests.
authors.affiliation: Université d'Angers, Laboratoire Angevin de Recherche en Ingénierie des Systèmes (LARIS)-EA7315 F-49000 France, LUNAM, Université d'Angers, Département de Médecine Physique et de Réadaptation, CHU Angers, F-49933, France.
authors.forename: Mickael
authors.initials: M
authors.lastname: Dinomais
authors.affiliation: Service de Physiologie Clinique et de l'Exercice, CHU, Saint-Etienne, France, EA 4607 "SNA EPIS" Faculté de Médecine J Lisfranc UJM, PRES Université de Lyon, F-42023, France.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Celle
authors.affiliation: Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, Angers University Hospital, UPRES EA 4638, University of Angers, UNAM, Angers, France.
authors.forename: Guillaume T
authors.initials: GT
authors.lastname: Duval
authors.affiliation: Service de Physiologie Clinique et de l'Exercice, CHU, Saint-Etienne, France, EA 4607 "SNA EPIS" Faculté de Médecine J Lisfranc UJM, PRES Université de Lyon, F-42023, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Roche
authors.affiliation: Department of Sports Medicine and Vascular Investigations, University Hospital, Angers, France.
authors.forename: Samir
authors.initials: S
authors.lastname: Henni
authors.affiliation: Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Ontario, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Bartha
authors.affiliation: Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada.
authors.forename: Olivier
authors.initials: O
authors.lastname: Beauchet
authors.affiliation: Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, Angers University Hospital, UPRES EA 4638, University of Angers, UNAM, Angers, France.|Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Ontario, Canada.
authors.forename: Cedric
authors.identifier: http://orcid.org/0000-0002-7199-8109
authors.initials: C
authors.lastname: Annweiler
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000503:physiopathology; D000679:Amygdala / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D001921:Brain / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D060825:Cognitive Dysfunction / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D066128:Gray Matter / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006624:Hippocampus / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D066127:White Matter / Q000033:anatomy & histology / Q000000981:diagnostic imaging