Incidental findings on brain MRI of cognitively normal first-degree descendants of patients with Alzheimer's disease: a cross-sectional analysis from the ALFA (Alzheimer and Families) project.
To describe the prevalence of brain MRI incidental findings (IF) in a cohort of cognitively normal first-degree descendants of patients with Alzheimer's disease (AD).



Cross-sectional observational study.



All scans were obtained with a 3.0 T scanner. Scans were evaluated by a single neuroradiologist and IF recorded and categorised. The presence of white matter hyperintensities (WMH) was determined with the Fazekas scale and reported as relevant if ≥2.



575 participants (45-75 years) underwent high-resolution structural brain MRI. Participants were cognitively normal and scored over the respective cut-off values in all the following neuropsychological tests: Mini-Mental State Examination (≥26), Memory Impairment Screen (≥6), Time Orientation Subtest of the Barcelona Test II (≥68), verbal semantic fluency (naming animals ≥12). Clinical Dementia Rating (CDR) had to be 0.



155 participants (27.0%) presented with at least one IF. Relevant WMH were present in 7.8% of the participants, and vascular abnormalities, cyst and brain volume loss in 10.7%, 3.1% and 6.9% of the study volunteers, respectively. Neoplastic brain findings were found in 2.4% of participants and within these, meningiomas were the most common (1.7%) and more frequently found in women. A positive correlation between increasing age and the presence of IF was found. Additionally, brain atrophy greater than that expected by age was significantly more prevalent in participants without a parental history of AD.



Brain MRIs of healthy middle-aged participants show a relatively high prevalence of IF even when study participants have been screened for subtle cognitive alterations. Most of our participants are first-degree descendants of patients with AD, and therefore these results are of special relevance for novel imaging studies in the context of AD prevention in cognitively healthy middle-aged participants.



NCT02198586.
Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.
Anna
A
Brugulat-Serrat
Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.|Unit of Human Anatomy and Embryology, Faculty of Medicine, Department of Morphological Sciences, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
Santiago
S
Rojas
Magnetic Resonance Imaging Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.|Centre Mèdic Diagnòstic Alomar, Barcelona, Spain.
Nuria
N
Bargalló
Servicio de Neurocirugía, Hospital del Mar, Barcelona, Spain.
Gerardo
G
Conesa
Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.
Carolina
C
Minguillón
Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.
Karine
K
Fauria
Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.
Nina
N
Gramunt
Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.
José Luis
JL
Molinuevo
Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain.
Juan Domingo
JD
Gispert
D000368:Aged; D000544:Alzheimer Disease / Q000503:physiopathology*; D001921:Brain / Q000503:physiopathology*; D003071:Cognition / Q000502:physiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data
Alzheimer's disease; cerebral MRI; healthy; incidental finding; late middle-aged; prevention