Alzheimer Hastalığını Hafif Bilişsel Bozukluktan Ayırmak İçin Basit Bir MRI-Tabanlı Görsel Kılavuz

Amaç: Bu çalışmada manyetik rezonans görüntülemede (MRI) hipokampus uzunluğunun görsel olarak değerlendirilmesi yoluyla hafif bilişsel bozukluk (HBB) ile Alzheimer hastalığı (AH) arasında ayrım yapmayı amaçladık. Gereç ve Yöntemler: HBB ve AH tanısı alan hastalar hastane bilgi yönetim sisteminden geriye dönük olarak tarandı. Hipokampus yüksekliğinde azalma olup olmaması ile hipokampal atrofinin tanımlanması MRI ile değerlendirildi. Hipokampusta yükseklik kaybı olan hastalar klinik araştırmacı tarafından AH olarak sınıflandırıldı ve hastaların tanıları sistem üzerinden daha sonra kontrol edildi. Bulgular: Çalışmaya AH (n=14) ve HBB (n=42) olan toplam 56 hasta dahil edildi. AH hastalarında HBB hastalarından anlamlı olarak daha fazla hipokampal atrofi vardı (χ2=6.222, SD=1, p=0.013). Sonuç: HBB ve AH arasındaki ayırıcı tanı kompleks bir konudur. MRI’a basit bir bakış, klinik rutinde hekime kısa bir fikir verebilir.

Anahtar Kelimeler:

hipokampus, Alzheimer hastalığı, hafif bilişsel bozukluk, MRI

A Simple MRI-Based Visual Guide To Differentiate Alzheimer’s Disease From Mild Cognitive İmpairment

Objective: To distinguish between mild cognitive impairment (MCI) and Alzheimer’s disease (AD) by visual assessment of the length of the hippocampus in magnetic resonance imaging (MRI). Material and Methods: Consecutive patients diagnosed with MCI and AD were retrospectively searched on the Hospital Information Management Systems. MRI was rated for hippocampal atrophy defining with and without loss of hippocampal length. Patients with loss of hippocampal height were classified as having AD by the clinical investigator, and the diagnosis of the patients was checked on the system. Results: A total of 56 memory clinic patients with AD (n=14) and MCI (n=42) were included in the study. AD patients had significantly more hippocampal atrophy than MCI patients (χ2=6.222, df=0.13, p=0.013). Conclusion: There is a complex issue in the differential diagnosis between MCI and AD. A simple glace to the MRI may give a brief opinion to the physician in the clinic routine

Keywords:

Alzheimer’s disease, mild cognitive impairment, hippocampus, MRI,

PDF

___

Grand JH, Caspar S, MacDonald SW. Clinical features and multidisciplinary approaches to dementia care. Journal of multidisciplinary healthcare. 2011;4:125.
Gaugler JE, Ascher-Svanum H, Roth DL, Fafowora T, Siderowf A, Beach TG. Characteristics of patients misdiagnosed with Alzheimer’s disease and their medication use: an analysis of the NACC-UDS database. BMC geriatrics. 2013;13(1):1-10.
Knopman DS, Petersen RC, editors. Mild cognitive impairment and mild dementia: a clinical perspective. Mayo Clinic Proceedings; 2014: Elsevier.
Jack Jr CR, Holtzman DM. Biomarker modeling of Alzheimer’s disease. Neuron. 2013;80(6):1347-58.
Achterberg HC, van der Lijn F, den Heijer T, Vernooij MW, Ikram MA, Niessen WJ, et al. Hippocampal shape is predictive for the development of dementia in a normal, elderly population. Human brain mapping. 2014;35(5):2359-71.
Sørensen L, Igel C, Pai A, Balas I, Anker C, Lillholm M, et al. Differential diagnosis of mild cognitive impairment and Alzheimer's disease using structural MRI cortical thickness, hippocampal shape, hippocampal texture, and volumetry. NeuroImage: Clinical. 2017;13:470-82.
Scheltens P, Leys D, Barkhof F, Huglo D, Weinstein H, Vermersch P, et al. Atrophy of medial temporal lobes on MRI in" probable" Alzheimer's disease and normal ageing: diagnostic value and neuropsychological correlates. Journal of Neurology, Neurosurgery & Psychiatry. 1992;55(10):967-72.
Adachi M, Kawakatsu S, Sato T, Ohshima F. Correlation between volume and morphological changes in the hippocampal formation in Alzheimer’s disease: rounding of the outline of the hippocampal body on coronal MR images. Neuroradiology. 2012;54(10):1079-87.
Shen Q, Loewenstein DA, Potter E, Zhao W, Appel J, Greig MT, et al. Volumetric and visual rating of magnetic resonance imaging scans in the diagnosis of amnestic mild cognitive impairment and Alzheimer’s disease. Alzheimer's & dementia. 2011;7(4):e101-e8.
Duara R, Loewenstein D, Potter E, Appel J, Greig M, Urs R, et al. Medial temporal lobe atrophy on MRI scans and the diagnosis of Alzheimer disease. Neurology. 2008;71(24):1986-92.
Belleville S, Fouquet C, Hudon C, Zomahoun HTV, Croteau J. Neuropsychological measures that predict progression from mild cognitive impairment to Alzheimer's type dementia in older adults: a systematic review and meta-analysis. Neuropsychology review. 2017;27(4):328-53.
Achterberg HC, Sørensen L, Wolters FJ, Niessen WJ, Vernooij MW, Ikram MA, et al. The value of hippocampal volume, shape, and texture for 11-year prediction of dementia: a population-based study. Neurobiology of aging. 2019;81:58-66.
Enache D, Cavallin L, Lindberg O, Farahmand B, Kramberger MG, Westman E, et al. Medial temporal lobe atrophy and depressive symptoms in elderly patients with and without Alzheimer disease. Journal of Geriatric Psychiatry and Neurology. 2015;28(1):40-8.