Combining Visual Rating Scales for Medial Temporal Lobe Atrophy and Posterior Atrophy to Identify Amnestic Mild Cognitive Impairment from Cognitively Normal Older Adults: Evidence Based on Two Cohorts

Article type: Research Article

Authors: Sheng, Can^{a; 1} | Sun, Yu^{a; 1} | Wang, Min^{b; 1} | Wang, Xiaoni^a | Liu, Yi^a | Pang, Dongqing^c | Liu, Jiaqi^c | Bi, Xiaoxia^c | Du, Wenying^a | Zhao, Mingyan^a | Li, Yuxia^a | Li, Xiaobo^d | Jiang, Jiehui^{b; *} | Han, Ying^{a; e; f; *}

Affiliations: [a] Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China | [b] Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai, China | [c] Department of Neurology, the First Hospital of Tsinghua University, Beijing, China | [d] Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA | [e] Center of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China | [f] National Clinical Research Center for Geriatric Disorders, Beijing, China

Correspondence: [*] Correspondence to: Ying Han, MD, PhD, Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China. Tel.: +86 18515692701; Fax: +86 10 83167306; E-mail: hanying@xwh.ccmu.edu.cn and Jiehui Jiang, PhD, Shanghai Institute for Advanced Communication and Data Science, Shanghai University, 99 Shangda Road, Shanghai 200444, China. E-mail: jiangjiehui@shu.edu.cn.

Note: [1] These authors contributed equally to this work.

Abstract: Background:Visual rating scales for medial temporal lobe atrophy (MTA) and posterior atrophy (PA) have been reported to be useful for Alzheimer’s disease diagnosis in routine clinical practice. Objective:To investigate the efficacy of combined MTA and PA visual rating scales to discriminate amnestic mild cognitive impairment (aMCI) patients from healthy controls. Methods:This study included T1-weighted MRI images from two different cohorts. In the first cohort, we recruited 73 patients with aMCI and 48 group-matched cognitively normal controls for training and validation. Visual assessments of MTA and PA were carried out for each participant. Global gray matter volume and density were estimated using voxel-based morphometry analysis as the objective reference. We investigated the discriminative power of a single visual rating scale and the combination of the MTA and PA rating scales for identifying aMCI. The second cohort, consisting of 33 aMCI patients and 45 controls, was used to verify the reliability of the visual assessments. Results:Compared with the single visual rating scale, the combination of the MTA and PA exhibited the best discriminative power, with an AUC of 0.818±0.041, which was similar to the diagnostic accuracy of the gray matter volumetric measures. The discriminative power of the combined MTA and PA was verified in the second cohort (AUC 0.824±0.058). Conclusion:The combined MTA and PA rating scales demonstrated practical diagnostic value for distinguishing aMCI patients from controls, suggesting its potential to serve as a convenient and reproducible method to assess the degree of atrophy in clinical settings.

Keywords: Magnetic resonance imaging, medial temporal lobe atrophy, mild cognitive impairment, posterior atrophy, visual rating scales

DOI: 10.3233/JAD-200016

Journal: Journal of Alzheimer's Disease, vol. 77, no. 1, pp. 323-337, 2020