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Lookup NU author(s): Dr Tuomo Polvikoski, Professor Raj KalariaORCiD, Dr Timo Erkinjuntti
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Background: Medial temporal lobe atrophy (MTA) is a sensitive radiologic marker for Alzheimer disease (AD) and associated with cognitive impairment. The value of MTA in the oldest old (>85 years old) is largely unknown. Methods: A total of 132 formalin-fixed brains from the Vantaa 85+ community-based study were subjected to postmortem MRI. Visual ratings of MTA were determined in a blinded fashion and compared with neuropathologic findings and clinical assessment (dementia according to Diagnostic and Statistical Manual of Mental Disorders-III-R). Results: A strong relationship was found between MTA scores and Alzheimer pathology (p < 0.001). The previously proposed cutoff MTA score >2 correctly excluded subjects with no or borderline Alzheimer-type pathology (45/48), but was not very sensitive for AD (modified National Institute on Aging-Reagan Institute criteria). MTA scores >2 were also found in subjects with other primary neurodegenerative hippocampal pathology including hippocampal sclerosis, Lewy-related pathology, and argyrophilic grain disease, either alone or in combination with Alzheimer-type pathology. High MTA scores were associated with clinical dementia—in this subgroup, sensitivity was 63% and specificity 69% for AD. Conclusion: Medial temporal lobe atrophy (MTA) on postmortem MRI is sensitive to primary degenerative hippocampal pathology in the very old, but not specific for Alzheimer-type pathology. MTA scores of 2 or less are not frequently associated with dementia.
Author(s): Barkhof F, Polvikoski T, van Straaten I, Kalaria RN, Sulkava R, Aronen H, Niinisto L, Rastas S, Oinas M, Scheltens P, Erkinjuntti T
Publication type: Article
Publication status: Published
Journal: Neurology
Year: 2007
Volume: 69
Issue: 15
Pages: 1521-1527
ISSN (print): 0028-3878
ISSN (electronic): 1526-632X
Publisher: Lippincott Williams & Wilkins
URL: http://dx.doi.org/10.1212/01.wnl.0000277459.83543.99
DOI: 10.1212/01.wnl.0000277459.83543.99
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