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A Comprehensive Visual Rating Scale of Brain Magnetic Resonance Imaging: Application in Elderly Subjects with Alzheimer's Disease, Mild Cognitive Impairment, and Normal Cognition

Article type: Research Article

Authors: Jang, Jae-Wona | Park, So Youngb; c | Park, Young Hob; c | Baek, Min Jaeb | Lim, Jae-Sungc; d | Youn, Young Chule | Kim, SangYunb; c; *

Affiliations: [a] Department of Neurology, Kangwon National University Hospital, Chuncheon, Republic of Korea | [b] Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea | [c] Department of Neurology, Seoul National University College of Medicine, Seoul, Korea | [d] Department of Neurology, Seoul National University Boramae Hospital, Seoul, Republic of Korea | [e] Department of Neurology, College of Medicine, Chung-Ang University, Seoul, Republic of Korea

Correspondence: [*] Correspondence to: SangYun Kim, MD, PhD, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463–707, Republic of Korea. Tel.: +82 31 787 7462; Fax: +82 31 719 6815; E-mail: neuroksy@snu.ac.kr.

Keywords: Alzheimer's disease, mild cognitive impairment, visual rating scale

DOI: 10.3233/JAD-142088

Journal: Journal of Alzheimer's Disease, vol. 44, no. 3, pp. 1023-1034, 2015

Accepted 12 October 2014
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Published: 6 February 2015
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Supplementary Materials:

Supplementary Material.

Abstract

Background:

Brain magnetic resonance imaging (MRI) shows cerebral structural changes. However, a unified comprehensive visual rating scale (CVRS) has seldom been studied. Thus, we combined brain atrophy and small vessel disease scales and used an MRI template as a CVRS.

Objective:

The aims of this study were to design a simple and reliable CVRS, validate it by investigating cerebral structural changes in clinical groups, and made comparison to the volumetric measurements.

Methods:

Elderly subjects (n = 260) with normal cognition (NC, n = 65), mild cognitive impairment (MCI, n = 101), or Alzheimer's disease (AD, n = 94) were evaluated with brain MRI according to the CVRS of brain atrophy and small vessel disease. Validation of the CVRS with structural changes, neuropsychological tests, and volumetric analyses was performed.

Results:

The CVRS revealed a high intra-rater and inter-rater agreement and it reflected the structural changes of subjects with NC, MCI, and AD better than volumetric measures (CVRS-coronal: F = 13.5, p < 0.001; CVRS-axial: F = 19.9, p < 0.001). The area under the receiver operation curve (aROC) of the CVRS showed higher accuracy than volumetric analyses. (NC versus MCI aROC: CVRS-coronal, 0.777; CVRS-axial, 0.773; MCI versus AD aROC: CVRS-coronal, 0.680; CVRS-axial, 0.681).

Conclusion:

The CVRS can be used clinically to conveniently measure structural changes of brain. It reflected cerebral structural changes of clinical groups and correlated with the age better than volumetric measures.

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