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AJNR - American Journal of Neuroradiology

Published ahead of print on February 22, 2008
doi: 10.3174/ajnr.A0949

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Amnestic Mild Cognitive Impairment: Structural MR Imaging Findings Predictive of Conversion to Alzheimer Disease

G. Karas^a,b,c, J. Sluimer^a,b,c, R. Goekoop^b,c, W. van der Flier^c, S.A.R.B. Rombouts^f,g,h, H. Vrenken^a,b, P. Scheltens^c,d, N. Fox^e and F. Barkhof^a,b,c

^a Department of Diagnostic Radiology, VU University Medical Center, Amsterdam, the Netherlands
^b Image Analysis Center, VU University Medical Center, Amsterdam, the Netherlands
^c Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands
^d Department of Clinical Neurology, VU University Medical Center, Amsterdam, the Netherlands
^e Dementia Research Group, Department of Clinical Neurology, Institute of Neurology, London, UK
^f Department of Physics and Medical Technology, Alzheimer Center, VU University Medical Center and Leiden Institute for Brain and Cognition, Leiden, the Netherlands
^g Department of Psychology, Leiden University, Leiden, the Netherlands
^h Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands

View larger version (45K): [in this window] [in a new window]   Fig 1. VBM contrast between converters and nonconverters by using a simple t test (no covariates). Areas with more atrophy in converters are superimposed on the average gray matter template. No threshold is applied so that the full extent of the results can be appreciated. Converters have more atrophy of the medial and lateral temporal lobes bilaterally and of the frontal and parietal lobes. Thresholded results corrected for multiple comparisons by using random field theory are displayed in Tables 4 and 5.

View larger version (59K): [in this window] [in a new window]   Fig 2. Rendering of the simple t test and full model (corrected for age, sex, NYU, and global gray matter) between MCI converters and nonconverters. The big yellow area on the left hemisphere denotes less gray matter (more atrophy) in the converters group, compared with nonconverters, as captured by the t test. After correcting for age, sex, global gray matter atrophy, and a neuropsychological measure that is a good predictor of conversion to AD (NYU), atrophy in the left lateral temporal lobe and left parietal regions remains statistically significant, depicted as red. Results were thresholded at P = .001 uncorrected for multiple comparisons for display purposes.

View larger version (129K): [in this window] [in a new window]   Fig 3. Coronal multiplanar reconstructions of a structural T1-weighted MR imaging volume. There is slight hippocampal atrophy (open arrow) with concomitant widening of the collateral sulcus (closed kinked arrow), both signs of progressive MTA. Additionally note slight parietal atrophy (closed arrow), which adds independent predictive value for conversion from mild cognitive impairment to AD.