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Medial temporal atrophy in preclinical dementia : Visual and automated assessment during six year follow-up

Mårtensson, Gustav ; Håkansson, Claes LU ; Pereira, Joana B. LU ; Palmqvist, Sebastian LU orcid ; Hansson, Oskar LU orcid ; van Westen, Danielle LU orcid and Westman, Eric (2020) In NeuroImage: Clinical 27.
Abstract

Medial temporal lobe (MTL) atrophy is an important morphological marker of many dementias and is closely related to cognitive decline. In this study we aimed to characterize longitudinal progression of MTL atrophy in 93 individuals with subjective cognitive decline and mild cognitive impairment followed up over six years, and to assess if clinical rating scales are able to detect these changes. All MRI images were visually rated according to Scheltens’ scale of medial temporal atrophy (MTA) by two neuroradiologists and AVRA, a software for automated MTA ratings. The images were also segmented using FreeSurfer's longitudinal pipeline in order to compare the MTA ratings to volumes of the hippocampi and inferior lateral ventricles. We... (More)

Medial temporal lobe (MTL) atrophy is an important morphological marker of many dementias and is closely related to cognitive decline. In this study we aimed to characterize longitudinal progression of MTL atrophy in 93 individuals with subjective cognitive decline and mild cognitive impairment followed up over six years, and to assess if clinical rating scales are able to detect these changes. All MRI images were visually rated according to Scheltens’ scale of medial temporal atrophy (MTA) by two neuroradiologists and AVRA, a software for automated MTA ratings. The images were also segmented using FreeSurfer's longitudinal pipeline in order to compare the MTA ratings to volumes of the hippocampi and inferior lateral ventricles. We found that MTL atrophy rates increased with CSF biomarker abnormality, used to define preclinical stages of Alzheimer's Disease. Both AVRA's and the radiologists’ MTA ratings showed similar longitudinal trends as the subcortical volumes, suggesting that visual rating scales provide a valid alternative to automatic segmentations. Our results further showed that it took more than 8 years on average for individuals with mild cognitive impairment, and an Alzheimer's disease biomarker profile, to increase the MTA score by one. This suggests that discrete MTA ratings are too coarse for tracking individual MTL atrophy in short time spans. While the MTA scores from each radiologist showed strong correlations to subcortical volumes, the inter-rater agreement was low. We conclude that the main limitation of quantifying MTL atrophy with visual ratings in clinics is the subjectiveness of the assessment.

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author
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organization
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type
Contribution to journal
publication status
published
subject
in
NeuroImage: Clinical
volume
27
article number
102310
publisher
Elsevier
external identifiers
  • pmid:32580125
  • scopus:85086665303
ISSN
2213-1582
DOI
10.1016/j.nicl.2020.102310
language
English
LU publication?
yes
id
d20283d2-e960-4c32-8ecc-a22a39e44c5e
date added to LUP
2021-01-11 10:10:35
date last changed
2024-05-03 00:07:09
@article{d20283d2-e960-4c32-8ecc-a22a39e44c5e,
  abstract     = {{<p>Medial temporal lobe (MTL) atrophy is an important morphological marker of many dementias and is closely related to cognitive decline. In this study we aimed to characterize longitudinal progression of MTL atrophy in 93 individuals with subjective cognitive decline and mild cognitive impairment followed up over six years, and to assess if clinical rating scales are able to detect these changes. All MRI images were visually rated according to Scheltens’ scale of medial temporal atrophy (MTA) by two neuroradiologists and AVRA, a software for automated MTA ratings. The images were also segmented using FreeSurfer's longitudinal pipeline in order to compare the MTA ratings to volumes of the hippocampi and inferior lateral ventricles. We found that MTL atrophy rates increased with CSF biomarker abnormality, used to define preclinical stages of Alzheimer's Disease. Both AVRA's and the radiologists’ MTA ratings showed similar longitudinal trends as the subcortical volumes, suggesting that visual rating scales provide a valid alternative to automatic segmentations. Our results further showed that it took more than 8 years on average for individuals with mild cognitive impairment, and an Alzheimer's disease biomarker profile, to increase the MTA score by one. This suggests that discrete MTA ratings are too coarse for tracking individual MTL atrophy in short time spans. While the MTA scores from each radiologist showed strong correlations to subcortical volumes, the inter-rater agreement was low. We conclude that the main limitation of quantifying MTL atrophy with visual ratings in clinics is the subjectiveness of the assessment.</p>}},
  author       = {{Mårtensson, Gustav and Håkansson, Claes and Pereira, Joana B. and Palmqvist, Sebastian and Hansson, Oskar and van Westen, Danielle and Westman, Eric}},
  issn         = {{2213-1582}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{NeuroImage: Clinical}},
  title        = {{Medial temporal atrophy in preclinical dementia : Visual and automated assessment during six year follow-up}},
  url          = {{http://dx.doi.org/10.1016/j.nicl.2020.102310}},
  doi          = {{10.1016/j.nicl.2020.102310}},
  volume       = {{27}},
  year         = {{2020}},
}