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Cerebral volume loss, cognitive deficit and neuropsychological performance: Comparative measures of brain atrophy: I. Dementia

Published online by Cambridge University Press:  01 May 2004

ERIN D. BIGLER
Affiliation:
Brigham Young University, Provo, Utah Department of Radiology, University of Utah, Salt Lake City, Utah LDS Hospital, Salt Lake City, Utah
E. SHANNON NEELEY
Affiliation:
Brigham Young University, Provo, Utah
MICHAEL J. MILLER
Affiliation:
Brigham Young University, Provo, Utah
DAVID F. TATE
Affiliation:
Brigham Young University, Provo, Utah
SARA A. RICE
Affiliation:
Brigham Young University, Provo, Utah
HOWARD CLEAVINGER
Affiliation:
Brigham Young University, Provo, Utah
LARA WOLFSON
Affiliation:
Brigham Young University, Provo, Utah
JOANN TSCHANZ
Affiliation:
Utah State University, Logan, Utah
KATHLEEN WELSH-BOHMER
Affiliation:
Duke University, Durham, North Carolina

Abstract

There are several magnetic resonance (MR) imaging methods to measure brain volume and cerebral atrophy; however, the best measure for examining potential relationships between such measures and neuropsychological performance has not been established. Relationships between seven measures of MR derived brain volume or indices of atrophy and neuropsychological performance in the elderly subjects of the population-based Cache County, Utah Study of Aging and Memory (n = 195) were evaluated. The seven MR measures included uncorrected total brain volume (TBV), TBV corrected by total intracranial volume (TICV), TBV corrected by the ratio of the individuals TICV by group TICV (TBVC), a ventricle-to-brain ratio (VBR), total ventricular volume (TVV), TVV corrected by TICV, and a measure of parenchymal volume loss. The cases from the Cache County Study were comprised of elderly individuals classified into one of four subject groups based on a consensus diagnostic process, independent of quantitative MR imaging findings. The groups included subjects with Alzheimer's disease (AD, n = 85), no dementia but mild/ambiguous (M/A) deficits (n = 30), a group of subjects with non-AD dementia or neuropsychiatric disorder including vascular dementia (n = 60), and control subjects (n = 20). Neuropsychological performance was based on the Mini-Mental Status Exam (MMSE) and an expanded neuropsychological test battery (consortium to establish a registry for Alzheimer's disease (CERAD). The results demonstrated that the various quantitative MR measures were highly interrelated and no single measure was statistically superior. However, TBVC, TBV/TICV and VBR consistently exhibited the more robust relationships with neuropsychological performance. These results suggest that a single corrected brain volume measure or index is sufficient in studies examining global MR indicators of cerebral atrophy in relation to cognitive function and recommends use of either TBVC, TBV/TICV, or VBR. (JINS, 2004, 10, 442–452.)

Type
Research Article
Copyright
© 2004 The International Neuropsychological Society

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