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Evaluation and clinical correlation of practical cut-offs for visual rating scales of atrophy: normal aging versus mild cognitive impairment and Alzheimer’s disease

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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.

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Authors and Affiliations

  1. Department of Radiology, AZ Groeninge, Kortrijk, Belgium

    Anne-Sophie Vanhoenacker

  2. Department of Radiology, AZ Sint-Lucas, Brugge, Belgium

    Bernard Sneyers

  3. Department of Radiology, University Hospitals, Louvain, Belgium

    Frederik De Keyzer & Philippe Demaerel

  4. Department of Radiology, Jessa Hospital, Hasselt, Belgium

    Sam Heye

Authors
  1. Anne-Sophie Vanhoenacker
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  2. Bernard Sneyers
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  3. Frederik De Keyzer
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  4. Sam Heye
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  5. Philippe Demaerel
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Corresponding author

Correspondence to Bernard Sneyers.

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Conflicts of interest

There were no conflicts of interest.

Ethical approval

This retrospective study was carried out at the Department of Neuroradiology at the University hospitals Gasthuisberg in Leuven, Belgium. Approval of the UZ Leuven Commission of Medical Ethics was obtained.

Informed consent

Informed consent was not necessary in this retrospective study.

Additional information

Anne-Sophie Vanhoenacker and Bernard Sneyers are joined first authors.

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Fig. 4.
figure 4

MTA score and suggested cut-off values

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Vanhoenacker, AS., Sneyers, B., De Keyzer, F. et al. Evaluation and clinical correlation of practical cut-offs for visual rating scales of atrophy: normal aging versus mild cognitive impairment and Alzheimer’s disease. Acta Neurol Belg 117, 661–669 (2017). https://doi.org/10.1007/s13760-017-0777-8

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  • DOI: https://doi.org/10.1007/s13760-017-0777-8

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