Affiliations: [a] Department of Neurology, Oregon Health & Science University, Portland, OR, USA | [b] Department of Medicine and Preventative Medicine, Oregon Health & Science University, Portland, OR, USA | [c] Department of Radiology, Oregon Health & Science University, Portland, OR, USA | [d] Portland Veterans Affairs Medical Center, Portland, OR, USA | [e] University of Alberta, Canada
Correspondence:
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Corresponding author: Jeffrey A. Kaye, MD, Layton Aging and Alzheimer's Disease Center, CR-131, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239, USA. Tel.: +1 503 494 6976; Fax: +1 503 494 7499; E-mail: kaye@ohsu.edu.
Abstract: To determine if rates and locations of brain volume loss associated with AD are phase-specific, occurring prior to clinical onset and at later stages, we performed longitudinal volumetric MRI analysis on 155 subjects enrolled in a prospective study of aging and dementia. Subjects were divided by Clinical Dementia Rating (CDR) scale into stages of Normal (CDR 0 → 0), Very Mild (CDR 0 → 0.5 and 0.5 → 0.5), Mild (CDR 0.5 → 1.0 and 1.0 → 1.0) and Moderate (CDR 1.0 → 2.0 and 2.0 → 2.0) dementia. Rates of volume change in CSF spaces, lobar and medial temporal lobe regions were analyzed for group differences across stages. Annual rates of ventricular volume change differed between non-demented and very mild group (p<0.01). In later severity stages, ventricular, temporal, basal ganglia-thalamic region and total volumes show change. Rates of volume loss increase as dementia progresses, but not uniformly in all regions. These regional and phase-specific volume changes form targets for monitoring disease-modifying therapies at clinically relevant, defined stages of dementia.
