Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai, China.
J Alzheimers Dis. 2020;77(1):323-337. doi: 10.3233/JAD-200016.
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.
To investigate the efficacy of combined MTA and PA visual rating scales to discriminate amnestic mild cognitive impairment (aMCI) patients from healthy controls.
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.
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).
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.
已有研究报道，内侧颞叶萎缩（MTA）和后部萎缩（PA）的视觉评分量表在常规临床实践中对阿尔茨海默病的诊断具有一定的作用。
旨在探究联合 MTA 和 PA 视觉评分量表鉴别遗忘型轻度认知障碍（aMCI）患者与健康对照者的效果。
本研究纳入了来自两个不同队列的 T1 加权 MRI 图像。在第一队列中，我们招募了 73 例 aMCI 患者和 48 名年龄、性别相匹配的认知正常对照者用于训练和验证。对每位参与者进行 MTA 和 PA 的视觉评估。采用基于体素的形态测量分析来估计全脑灰质体积和密度作为客观参考。我们研究了单一视觉评分量表和 MTA 和 PA 评分量表联合对识别 aMCI 的区分能力。第二队列由 33 例 aMCI 患者和 45 例对照者组成，用于验证视觉评估的可靠性。
与单一视觉评分量表相比，MTA 和 PA 的联合评分具有最佳的区分能力，AUC 为 0.818±0.041，与灰质体积测量的诊断准确性相似。在第二队列中验证了联合 MTA 和 PA 的区分能力（AUC 0.824±0.058）。
MTA 和 PA 联合评分量表在区分 aMCI 患者与对照组方面具有实用的诊断价值，提示其有可能成为一种方便且可重复的方法，用于评估临床环境中的萎缩程度。
