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Methodological problems and clinical relevance of structural neuroimaging in dementia research

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Summary

Structural neuroimaging and dementia are conceptually different being only loosely correlated. Computed tomography or magnetic resonance imaging can never “prove” a clinical syndrome such as dementia, but yield clues as to its cause and the site and extent of pathological changes. Conversely, the type and degree of intellectual deterioration can hardly predict neuroradiological findings. The value of structural neuroimaging lies in detecting or excluding possible causes of dementia and quantifying linear or volumetric parameters of tissue and fluid volume. If based on a presumed or established etiology, however, specific neuropsychological and dementia syndromes may correspond to focal pathological changes seen in well-defined cerebral areas as recent investigations have shown with hippocampal atrophy in Alzheimer's dementia.

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References

  • Albert M, Naeser MA, Levine HL, Garvey AJ (1984 a) Ventricular size in patients with presenile dementia of Alzheimer's type. Arch Neurol 41: 1258–1263

    PubMed  Google Scholar 

  • Albert M, Naeser MA, Levine HL, Garvey AJ (1984 b) CT density numbers in patients with senile dementia of the Alzheimer's type. Arch Neurol 41: 1264–1269

    PubMed  Google Scholar 

  • American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, 3rd ed, revised. American Psychiatric Association, Washington DC

    Google Scholar 

  • Barren SA, Jakobs L, Kinkel WR (1976) Changes in size of normal lateral ventricles during aging determined by computerized tomography. Neurology 26: 1011–1013

    PubMed  Google Scholar 

  • Bigler ED, Hubler DW, Cullum CM, Turkheimer E (1985) Intellectual and memory impairment: CT volume correlations. J Nerv Ment Dis 173: 347–352

    PubMed  Google Scholar 

  • Bondareff W, Raval J, Woo B, Hauser DL (1990) Magnetic resonance imaging and the severity of dementia in old adults. Arch Gen Psychiatry 47: 47–51

    PubMed  Google Scholar 

  • Bracco L, Campani D, Baratti E, Lippi A, Inzitari D, Pracucci G, Amaducci L (1993) Relation between MRI features and dementia in cerebrovascular disease patients with leukoaraiosis: a longitudinal study. J Neurol Sci 120: 131–136

    PubMed  Google Scholar 

  • Breteler MMB, van Swieten JC, Bots ML, Grobbee DE, Claus JJ, van den Hout JHW, van Harskamp F, Tanghe HLJ, de Jong PTVM, van Gijn J, Hofman A (1994) Cerebral white matter lesions, vascular risk factors, and cognitive function in a populationbased study: the Rotterdam study. Neurology 44: 1246–1252

    PubMed  Google Scholar 

  • Burns A, Pearlson G (1994) Computed tomography. In: Burns A, Levy R (eds) Dementia. Chapman & Hall, London, pp 407–426

    Google Scholar 

  • Burns A, Jacoby R, Levy R (1991) Computed tomography in Alzheimer s disease: a longitudinal study. Biol Psychiatry 29: 383–390

    PubMed  Google Scholar 

  • Busse O, Agnoli AL, Lippmann R, Schütz HJ (1981) Klinische Bedeutung der Ventrikelerweiterung und Rindenatrophie im Computertomogramm. Radiologie 21: 91–97

    Google Scholar 

  • Cala LA, Thickbroom GW, Black JL, Collins DWK, Mastaglia FL (1981) Brain density and cerebrospinal fluid space size: CT of normal volunteers. Am J Neuroradiol 2: 41–47

    PubMed  Google Scholar 

  • Cummings JL, Benson DF (1992) Dementia. A clinical approach. Butterworth-Heinemann, Boston

    Google Scholar 

  • Cuénod CA, Denys A, Michot JL, Jehenson P, Forette F, Kaplan D, Syrota A, Boller F (1993) Amygdala atrophy in Alzheimer's disease. Arch Neurol 50: 941–945

    PubMed  Google Scholar 

  • De Carli C, Kaye A, Horwitz B, Rapoport SJ (1990) Critical analysis of the use of computer assisted transverse axial tomography to study human brain in aging and dementia of the Alzheimer type. Neurology 40: 872–883

    PubMed  Google Scholar 

  • De Leon MJ (1993) Hippocampal formation atrophy in ageing and the prediction of Alzheimer's disease. In: Burns A (ed) Ageing and dementia. Arnold, London, pp 103–124

    Google Scholar 

  • De Leon MJ, George AE, Reisberg B, Ferris SH, Kluger A, Stylopoulos LA, Miller JD, La Regina ME, Chen C, Cohen J (1989) Alzheimer's disease: longitudinal CT studies of ventricular change. AJNR 10: 371–376

    Google Scholar 

  • De Reuck J, Dewo D, Strijckmans K, Lemahien I (1992) Does the severity of leukoaraiosis contribute to senile dementia? A comparative computerized and positron emission tomographic study. Eur Neurol 32: 199–205

    PubMed  Google Scholar 

  • Earnest MP, Heaton RK, Wilkinson WE, Manke WF (1979) Cortical atrophy, ventricular enlargement and intellectual impairment in the aged. Neurology 29: 1138–1143

    PubMed  Google Scholar 

  • Erkinjuntti T, Lee DH, Gao F, Steenhuis R, Eliasziw M, Fry R, Merskey H, Hachinski VC (1993) Temporal lobe atrophy on magnetic resonance imaging in the diagnosis of early Alzheimer's disease. Arch Neurol 50: 305–310

    PubMed  Google Scholar 

  • Freedman FM, Knoefel J, Naeser M, Levine H (1984) Computerized axial tomography in aging. In: Albert ML (ed) Clinical neurology of aging. Oxford, New York, pp 139–148

  • Golomb J, De Leon MJ, Kluger A, George AE, Tarshish C, Ferris SH (1993) Hippocampal atrophy in normal aging. Arch Neurol 50: 967–973

    PubMed  Google Scholar 

  • Grafton ST, Sumi SM, Stimac GK, Alvord EC, Shaw CM, Nochlin D (1991) Comparison of postmortem magnetic imaging and neuropathologic findings in the cerebral white matter. Arch Neurol 48: 293–298

    PubMed  Google Scholar 

  • Gyldenstedt C (1977) Measurements of the normal ventricular system and hemispheric sulci of 100 adults with computed tomography. Neuroradiology 14: 183–192

    PubMed  Google Scholar 

  • Killiany RJ, Moss MB, Albert MS, Sandor T, Tieman J, Jolesz F (1993) Temporal lobe regions on magnetic resonance imaging identify patients with early Alzheimer's disease. Arch Neurol 50: 949–954

    PubMed  Google Scholar 

  • Kozachuk WE, De Carli C, Schapiro MB, Wagner EE, Rapaport SI, Horwitz B (1990) White matter hyperintensities in dementia of Alzheimer's type and in healthy subjects without cerebrovascular risk factors. A magnetic resonance imaging study. Arch Neurol 47: 1306–1310

    PubMed  Google Scholar 

  • Lang C (1985) Is direct caudatometry superior to indirect parameters in confirming Huntington's disease? Neuroradiology 27: 161–163

    PubMed  Google Scholar 

  • Lang C (1991) Zur Interrelation bildgebender und psychometrischer Verfahren bei neurotoxikologischen Fragestellungen in der Arbeits- und Umwelt-Medizin. Arbeitsmed Sozialmed Präventivmed 26: 433–438

    Google Scholar 

  • Lang C (1994) Demenzen. Diagnose und Differentialdiagnose dementiver Erkrankungen des Erwachsenenalters. Chapman & Hall, Weinheim

    Google Scholar 

  • Lang C, Herholz K, Huk W, Feistel H (1990) Die diagnostische Differenzierung dementieller Erkrankungen durch moderne bildgebende Verfahren. Fortschr Neurol Psychiat 58: 380–398

    PubMed  Google Scholar 

  • Mirsen TR, Merskey H (1994) Leukoaraiosis. In: Burns A, Levy R (eds) Dementia. Chapman & Hall, London, pp 641–652

    Google Scholar 

  • Nagata K, Basugi N, Fukushima T, Tango T, Suzuki I, Kaminuma T, Kurashima S (1987) A quantitative study of physiological cerebral atrophy with aging. Neuroradiology 29: 327–332

    PubMed  Google Scholar 

  • Naugle R, Bigler ED (1989) Brain imaging and neuropsychological identification of dementia of the Alzheimer 's type. In: Bigler ED, Yeo RA, Turkheimer E (eds) Neuropsychological function and brain imaging. Plenum, New York, pp 185–218

    Google Scholar 

  • Naugle R, Cullum CM, Bigler ED, Massman PJ (1983) Neuropsychological and computerized axial tomography volume characteristics of empirically derived dementia subgroups. J Nerv Ment Dis 173: 596–604

    Google Scholar 

  • Reisner T, Zeiler K, Strobl G (1980) Quantitative Erfassung der Scitenventrikelbreite im CT — Vergleichswerte einer Normalpopulation. Fortschr Neurol Psychiat 48: 168–174

    Google Scholar 

  • Sandor T, Jolesz F, Tieman J, Kikinis R, Jones K, Albert M (1992) Comparative analysis of computed tomographic and magnetic resonance imaging scans in Alzheimer patients and controls. Arch Neurol 49: 381–384

    PubMed  Google Scholar 

  • Schmidt T (1992) Comparison of magnetic resonance imaging in Alzheimer's disease, vascular dementia and normal aging. Eur Neurol 32: 164–169

    PubMed  Google Scholar 

  • Stafford JL, Albert MS, Naeser MA, Sandor T, Garvey AJ (1988) Age-related differences in computed tomographic scan measurements. Arch Neurol 45: 409–415

    PubMed  Google Scholar 

  • Sullivan EV, Shear PK, Mathalon DH, Lim KO, Yesavage JA, Tinklenberg JR, Pfefferbaum A (1993) Greater abnormalities of brain cerebrospinal fluid volumes in younger than in older patients with Alzheimer's disease. Arch Neurol 50: 359–373

    PubMed  Google Scholar 

  • Tien RD, Felsberg GJ, Ferris NJ, Osumi AK (1993) The dementias: correlation of clinical features, pathophysiology, and neuroradiology. Am J Radiol 161: 245–255

    Google Scholar 

  • Willmer J, Carruthers A, Guzman DA, Collins B, Pogue J, Stuss DT (1993) The usefulness of CT scanning in diagnosing dementia of the Alzheimer type. Can J Neurol Sci 20: 210–216

    PubMed  Google Scholar 

  • Wohl MA, Mehringer CM, Lesser IM, Boone KB, Miller BL (1994) White matter hyperintensities in healthy older adults: a longitudinal study. Int J Geriatr Psychiatry 9: 273–277

    Google Scholar 

  • Ylikoski R, Ylikoski A, Erkinjuntti T, Sulkava R, Raininko R, Tilvis R (1993) White matter changes in healthy elderly persons correlate with attention and speed of mental processing. Arch Neurol 50: 818–824

    PubMed  Google Scholar 

  • Zatz LM, Jernigan TL, Ahumada AJ (1982 a) Changes on computed cranial tomography with aging: intracranial fluid volume. Am J Neuroradiol 3: 1–11

    PubMed  Google Scholar 

  • Zatz LM, Jernigan TL, Ahumada AJ (1982 b) White matter changes in cerebral computed tomography related to aging. J Comput Assist Tomogr 6: 19–23

    PubMed  Google Scholar 

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Revised and extended version of a paper presented at the 18th AGNP-Symposium on Structure and Function “Methodological Problems of Neuroradiology and Neurophysiology in Psychiatric Research”, Nuremberg, October 8, 1993

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Lang, C.J.G. Methodological problems and clinical relevance of structural neuroimaging in dementia research. J. Neural Transmission 99, 131–143 (1995). https://doi.org/10.1007/BF01271474

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