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T1-weighted Axial Visual Rating Scale for an Assessment of Medial Temporal Atrophy in Alzheimer's Disease

Article type: Research Article

Authors: Kim, Geon Haa | Kim, Jung-Euna | Choi, Kyoung-Gyua | Lim, Soo Meeb | Lee, Jong-Minc | Na, Duk L.d | Jeong, Jee Hyanga; *

Affiliations: [a] Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea | [b] Department of Radiology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea | [c] Department of Biomedical Engineering, Hanyang University, Seoul, Korea | [d] Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence: [*] Correspondence to: Jee Hyang Jeong, MD, PhD, Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine [158-710], 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, Korea. Tel.: +82 2 2650 2776; Fax: +82 2 2650 2652; E-mail: jjeong@ewha.ac.kr.

Keywords: Alzheimer's disease, medial temporal atrophy, visual rating scale

DOI: 10.3233/JAD-132333

Journal: Journal of Alzheimer's Disease, vol. 41, no. 1, pp. 169-178, 2014

Accepted 15 January 2014
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Published: 4 June 2014
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Supplementary Materials:

Supplementary Table 1.

Abstract

Background:

The most-widely used visual rating scale (VRS) for medial temporal atrophy is the T1-weighted (T1W) coronal VRS developed by Scheltens et al. However, it is often difficult to use the T1W-coronal VRS in cases with limitations in obtaining T1W-coronal images. To overcome this issue, we modified the T1W-coronal VRS onto the axial plane.

Objective:

The purposes of this study were to validate our T1W-axial VRS by examining its compatibility with the original T1W-coronal VRS and by investigating the correlation with the cognitive functions and hippocampal volumes.

Methods:

Participants were 50 patients with Alzheimer’s disease dementia and 30 elderly with normal cognition. We transposed each component of the T1W-coronal VRS onto T1W-axial images (i.e., the largest height of the hippocampal formation into the width of the medial temporal lobe). The compatibility of T1W-axial VRS with T1W-coronal one was determined using the kappa value. The correlations of T1W-axial VRS with cognitive performance or the hippocampal volumes were analyzed with age, gender, and education as covariates.

Results:

The kappa value between the T1W-axial and T1W-coronal VRS was 0.772 (p < 0.045). The T1W-axial VRS showed a significant correlation with the scores of cognitive functions, including verbal memory tests (−0.601, p < 0.001 for the left). Furthermore, the T1W-axial VRS also correlated well with hippocampal volumes (−0.576, p < 0.001).

Conclusions:

The T1W-axial VRS showed good agreement with T1W-coronal VRS and correlated well with cognitive functions as well as hippocampal volumes, which suggests that the T1-axial VRS may replace the original T1W-coronal one.

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