Center for Cognitive and Behavioral Disorders, IRCCS Mondino Foundation, Department of Brain and Behavior, University of Pavia, Italy; LANVIE-Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland.
LANVIE-Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland.
Neuroimage Clin. 2019;24:101936. doi: 10.1016/j.nicl.2019.101936. Epub 2019 Jul 15.
The medial temporal lobe atrophy (MTA) and the posterior atrophy (PA) scales allow to assess the degree hippocampal and parietal atrophy from magnetic resonance imaging (MRI) scans. Despite reliable, easy and widespread employment, appropriate normative values are still missing. We aim to provide norms for the Italian population.
Two independent raters assigned the highest MTA and PA score between hemispheres, based on 3D T1-weighted MRI of 936 Italian Brain Normative Archive subjects (age: mean ± SD: 50.2 ± 14.7, range: 20-84; MMSE>26 or CDR = 0). The inter-rater agreement was assessed with the absolute intraclass correlation coefficient (aICC). We assessed the association between MTA and PA scores and sociodemographic features and APOE status, and normative data were established by age decade based on percentile distributions.
Raters agreed in 90% of cases for MTA (aICC = 0.86; 95% CI = 0.69-0.98) and in 86% for PA (aICC = 0.82; 95% CI = 0.58-0.98). For both rating scales, score distribution was skewed, with MTA = 0 in 38% of the population and PA = 0 in 52%, while a score ≥ 2 was only observed in 12% for MTA and in 10% for PA. Median denoted overall hippocampal (MTA: median = 1, IQR = 0-1) and parietal (PA: median = 0, IQR = 0-1) integrity. The 90th percentile of the age-specific distributions increased from 1 (at age 20-59) for both scales, to 2 for PA over age 60, and up to 4 for MTA over age 80. Gender, education and APOE status did not significantly affect the percentile distributions in the whole sample, nor in the subset over age 60.
Our normative data for the MTA and PA scales are consistent with previous studies and overcome their main limitations (in particular uneven representation of ages and missing percentile distributions), defining the age-specific norms to be considered for proper brain atrophy assessment.
内侧颞叶萎缩（MTA）和后部萎缩（PA）量表可用于评估磁共振成像（MRI）扫描中海马体和顶叶萎缩的程度。尽管该方法可靠、简便且应用广泛，但仍缺乏适当的参考值。本研究旨在为意大利人群提供参考值。
两名独立的评分者根据意大利脑正常档案 936 名受试者的三维 T1 加权 MRI（年龄：平均值±标准差：50.2±14.7，范围：20-84；MMSE＞26 或 CDR=0），在半脑之间分配最高的 MTA 和 PA 评分。采用绝对组内相关系数（aICC）评估评分者间的一致性。我们评估了 MTA 和 PA 评分与社会人口学特征和 APOE 状态之间的关系，并根据百分位数分布按年龄十年建立了参考值数据。
对于 MTA，评分者的一致性为 90%（aICC=0.86；95%CI=0.69-0.98），对于 PA，一致性为 86%（aICC=0.82；95%CI=0.58-0.98）。对于这两个评分量表，评分分布均呈偏态分布，其中 MTA 评分中 38%的人群为 0，PA 评分中 52%的人群为 0，而 MTA 评分中仅 12%的人群和 PA 评分中 10%的人群的评分≥2。中位数表示整体海马体（MTA：中位数=1，IQR=0-1）和顶叶（PA：中位数=0，IQR=0-1）的完整性。年龄特异性分布的第 90 个百分位数从两个量表在 20-59 岁时的 1 增加到 PA 在 60 岁以上时的 2，以及 MTA 在 80 岁以上时的 4。性别、教育程度和 APOE 状态在整个样本中以及在 60 岁以上的亚组中均未显著影响百分位数分布。
本研究中 MTA 和 PA 量表的参考值与之前的研究一致，并克服了其主要局限性（特别是年龄代表性不均和缺少百分位数分布），为适当的脑萎缩评估定义了特定年龄的参考值。
