title: Evaluation and clinical correlation of practical cut-offs for visual rating scales of atrophy: normal aging versus mild cognitive impairment and Alzheimer's disease.
abstract: Age-related brain atrophy is a common finding, but neurodegenerative diseases such as Alzheimer's disease are associated with accelerated atrophy of the medial temporal lobe. In current practice for brain atrophy evaluation, several rating scales are being used such as the medial temporal atrophy (MTA), global cortical atrophy-frontal subscale (GCA-F) and posterior atrophy (PA) scales. Practical cut-offs to differentiate between normal and advanced brain atrophy are needed, because of their possible usefulness as a biomarker. A retrospective study was performed over a 1-year period resulting in a total of 79 subjects [27 patients with Alzheimer's disease (AD), 27 patients with minimal cognitive impairment (MCI) and 25 control subjects]. The MTA, GCA-F and PA scales were applied blinded and independent by two raters. Possible age- and disease-related cut-offs were computed. The MTA scale showed significantly better diagnostic performances and inter-rater agreement than the PA and GCA-F scales. We could not confirm the suggested MTA cut-off for each decade. However, an MTA score of >1 and >1.75 was considered pathological, respectively, in the population under and over 70 years. MTA can be of use in making distinction between age-related atrophy and abnormal increase of atrophy. Systematic assessment of regional brain atrophy through the use of MTA in MRI images could be a useful biomarker in aiding the early diagnosis of Alzheimer's disease.
authors.affiliation: Department of Radiology, AZ Groeninge, Kortrijk, Belgium.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Vanhoenacker
authors.affiliation: Department of Radiology, AZ Sint-Lucas, Brugge, Belgium. bernard.sneyers@student.kuleuven.be.
authors.forename: Bernard
authors.identifier: http://orcid.org/0000-0002-9484-7776
authors.initials: B
authors.lastname: Sneyers
authors.affiliation: Department of Radiology, University Hospitals, Louvain, Belgium.
authors.forename: Frederik
authors.initials: F
authors.lastname: De Keyzer
authors.affiliation: Department of Radiology, Jessa Hospital, Hasselt, Belgium.
authors.forename: Sam
authors.initials: S
authors.lastname: Heye
authors.affiliation: Department of Radiology, University Hospitals, Louvain, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Demaerel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology*; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000473:pathology*; D001284:Atrophy / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology*; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016037:Single-Blind Method
keywords: Alzheimer’s disease; Cortical atrophy; Mild cognitive impairment; Visual rating scales