Measuring brain atrophy in patients with mild cognitive impairment.

Scientists at the University of California, San Diego School of Medicine have shown that a fully automated procedure called Volumetric MRI - which measures the "memory centers" of the brain and compares them to expected size - is effective in predicting the progression from mild cognitive impairment (MCI) to Alzheimer's disease. The procedure can be readily used in clinics to measure brain atrophy, and may help physicians to predict decline in MCI patients. Their study has been published in the June issue of the journal Alzheimer Disease and Associated Disorders (see also University of California - San Diego).

"Use of this procedure is like bringing the experience of an expert neuro-radiologist to any clinic that has the right software," said James Brewer, MD, PhD, assistant professor in UC San Diego's Departments of Radiology and Neurosciences. "These fully automated and rapid methods of measuring medial temporal lobe volumes may help clinicians predict cognitive decline in their patients, and have the potential to influence how neurology is practiced."

Mild cognitive impairment (MCI) is considered a transitional stage between the forgetfulness associated with normal aging and Alzheimer's disease. Yet, many patients with MCI do not progress to Alzheimer's, and these individuals don't need treatments targeted to prevent or slow down neuro-degeneration. Therefore, objective measures are necessarily to distinguish MCI patients who will clinically decline from those who will remain stable.

"Our goal was to find neuroimaging measures of change that reflected more than merely a person's advancing age, but instead correlated tightly with how a person's cognitive status worsens over time," said co-author Michael Rafii, MD, PhD, assistant professor of neurosciences at UC San Diego. "It's too early to draw a definitive comparison, but it appears that these early changes - especially shrinking of the hippocampus - may offer a robust biological marker for change."

Medial temporal lobe atrophy has been associated with increased risk for conversion of MCI to Alzheimer's disease. However, until now, studies have focused only on measurements of the brain's hippocampus. The extent to which ...