Hippocampal volumes, proton magnetic resonance spectroscopy metabolites, and cerebrovascular disease in mild cognitive impairment subtypes

Kejal M Kantarci, Ronald Carl Petersen, Scott A. Przybelski, Stephen D. Weigand, Maria M. Shiung, Jennifer Lynn Whitwell, Selamawit Negash, Robert J. Ivnik, Bradley F Boeve, David S Knopman, Glenn E. Smith, Clifford R Jr. Jack

Research output: Contribution to journalArticle

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Abstract

Background: Although a majority of patients with amnestic mild cognitive impairment (aMCI) progress to Alzheimer disease, the natural history of nonamnestic MCI (naMCI) is less clear. Noninvasive imaging surrogates for underlying pathological findings in MCI would be clinically useful for identifying patients who may benefit from disease-specific treatments at the prodromal stage of dementia. Objective: To determine the characteristic magnetic resonance imaging (MRI) and proton MR spectroscopy ( 1H MRS) profiles of MCI subtypes. Design: Case-control study. Setting: Community-based sample at a tertiary referral center. Patients: Ninety-one patients with single-domain aMCI, 32 patients with multiple-domain aMCI, 20 patients with single- or multiple-domain naMCI, and 100 cognitively normal elderly subjects frequency-matched by age and sex. Main Outcome Measures: Posterior cingulate gyrus 1H MRS metabolite ratios, hippocampal volumes, and cerebrovascular disease on MRI. Results: Patients with single-domain aMCI were characterized by small hippocampal volumes and elevated ratios of myo-inositol to creatine levels. Patients with naMCI on average had normal hippocampal volumes and 1H MRS metabolite ratios, but a greater proportion (3 of 20 patients [15%]) had cortical infarctions compared with patients with single-domain aMCI (6 of 91 [7%]). For characterization of MCI subtypes, 1H MRS and structural MRI findings were complementary. Conclusions: The MRI and 1H MRS findings in single-domain aMCI are consistent with a pattern similar to that of Alzheimer disease. Absence of this pattern on average in patients with naMCI suggests that cerebrovascular disease and other neurodegenerative diseases may be contributing to the cognitive impairment in many individuals with naMCI.

Original languageEnglish (US)
Pages (from-to)1621-1628
Number of pages8
JournalArchives of Neurology
Volume65
Issue number12
DOIs
StatePublished - Dec 2008

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Cerebrovascular Disorders
Magnetic Resonance Imaging
Alzheimer Disease
Proton Magnetic Resonance Spectroscopy
Cognitive Dysfunction
Spectroscopy
Mild Cognitive Impairment
Prodromal Symptoms
Creatine
Gyrus Cinguli
Inositol
Natural History
Tertiary Care Centers
Neurodegenerative Diseases
Infarction
Dementia
Protons
Case-Control Studies
Magnetic Resonance Spectroscopy
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Hippocampal volumes, proton magnetic resonance spectroscopy metabolites, and cerebrovascular disease in mild cognitive impairment subtypes. / Kantarci, Kejal M; Petersen, Ronald Carl; Przybelski, Scott A.; Weigand, Stephen D.; Shiung, Maria M.; Whitwell, Jennifer Lynn; Negash, Selamawit; Ivnik, Robert J.; Boeve, Bradley F; Knopman, David S; Smith, Glenn E.; Jack, Clifford R Jr.

In: Archives of Neurology, Vol. 65, No. 12, 12.2008, p. 1621-1628.

Research output: Contribution to journalArticle

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abstract = "Background: Although a majority of patients with amnestic mild cognitive impairment (aMCI) progress to Alzheimer disease, the natural history of nonamnestic MCI (naMCI) is less clear. Noninvasive imaging surrogates for underlying pathological findings in MCI would be clinically useful for identifying patients who may benefit from disease-specific treatments at the prodromal stage of dementia. Objective: To determine the characteristic magnetic resonance imaging (MRI) and proton MR spectroscopy ( 1H MRS) profiles of MCI subtypes. Design: Case-control study. Setting: Community-based sample at a tertiary referral center. Patients: Ninety-one patients with single-domain aMCI, 32 patients with multiple-domain aMCI, 20 patients with single- or multiple-domain naMCI, and 100 cognitively normal elderly subjects frequency-matched by age and sex. Main Outcome Measures: Posterior cingulate gyrus 1H MRS metabolite ratios, hippocampal volumes, and cerebrovascular disease on MRI. Results: Patients with single-domain aMCI were characterized by small hippocampal volumes and elevated ratios of myo-inositol to creatine levels. Patients with naMCI on average had normal hippocampal volumes and 1H MRS metabolite ratios, but a greater proportion (3 of 20 patients [15{\%}]) had cortical infarctions compared with patients with single-domain aMCI (6 of 91 [7{\%}]). For characterization of MCI subtypes, 1H MRS and structural MRI findings were complementary. Conclusions: The MRI and 1H MRS findings in single-domain aMCI are consistent with a pattern similar to that of Alzheimer disease. Absence of this pattern on average in patients with naMCI suggests that cerebrovascular disease and other neurodegenerative diseases may be contributing to the cognitive impairment in many individuals with naMCI.",
author = "Kantarci, {Kejal M} and Petersen, {Ronald Carl} and Przybelski, {Scott A.} and Weigand, {Stephen D.} and Shiung, {Maria M.} and Whitwell, {Jennifer Lynn} and Selamawit Negash and Ivnik, {Robert J.} and Boeve, {Bradley F} and Knopman, {David S} and Smith, {Glenn E.} and Jack, {Clifford R Jr.}",
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T1 - Hippocampal volumes, proton magnetic resonance spectroscopy metabolites, and cerebrovascular disease in mild cognitive impairment subtypes

AU - Kantarci, Kejal M

AU - Petersen, Ronald Carl

AU - Przybelski, Scott A.

AU - Weigand, Stephen D.

AU - Shiung, Maria M.

AU - Whitwell, Jennifer Lynn

AU - Negash, Selamawit

AU - Ivnik, Robert J.

AU - Boeve, Bradley F

AU - Knopman, David S

AU - Smith, Glenn E.

AU - Jack, Clifford R Jr.

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N2 - Background: Although a majority of patients with amnestic mild cognitive impairment (aMCI) progress to Alzheimer disease, the natural history of nonamnestic MCI (naMCI) is less clear. Noninvasive imaging surrogates for underlying pathological findings in MCI would be clinically useful for identifying patients who may benefit from disease-specific treatments at the prodromal stage of dementia. Objective: To determine the characteristic magnetic resonance imaging (MRI) and proton MR spectroscopy ( 1H MRS) profiles of MCI subtypes. Design: Case-control study. Setting: Community-based sample at a tertiary referral center. Patients: Ninety-one patients with single-domain aMCI, 32 patients with multiple-domain aMCI, 20 patients with single- or multiple-domain naMCI, and 100 cognitively normal elderly subjects frequency-matched by age and sex. Main Outcome Measures: Posterior cingulate gyrus 1H MRS metabolite ratios, hippocampal volumes, and cerebrovascular disease on MRI. Results: Patients with single-domain aMCI were characterized by small hippocampal volumes and elevated ratios of myo-inositol to creatine levels. Patients with naMCI on average had normal hippocampal volumes and 1H MRS metabolite ratios, but a greater proportion (3 of 20 patients [15%]) had cortical infarctions compared with patients with single-domain aMCI (6 of 91 [7%]). For characterization of MCI subtypes, 1H MRS and structural MRI findings were complementary. Conclusions: The MRI and 1H MRS findings in single-domain aMCI are consistent with a pattern similar to that of Alzheimer disease. Absence of this pattern on average in patients with naMCI suggests that cerebrovascular disease and other neurodegenerative diseases may be contributing to the cognitive impairment in many individuals with naMCI.

AB - Background: Although a majority of patients with amnestic mild cognitive impairment (aMCI) progress to Alzheimer disease, the natural history of nonamnestic MCI (naMCI) is less clear. Noninvasive imaging surrogates for underlying pathological findings in MCI would be clinically useful for identifying patients who may benefit from disease-specific treatments at the prodromal stage of dementia. Objective: To determine the characteristic magnetic resonance imaging (MRI) and proton MR spectroscopy ( 1H MRS) profiles of MCI subtypes. Design: Case-control study. Setting: Community-based sample at a tertiary referral center. Patients: Ninety-one patients with single-domain aMCI, 32 patients with multiple-domain aMCI, 20 patients with single- or multiple-domain naMCI, and 100 cognitively normal elderly subjects frequency-matched by age and sex. Main Outcome Measures: Posterior cingulate gyrus 1H MRS metabolite ratios, hippocampal volumes, and cerebrovascular disease on MRI. Results: Patients with single-domain aMCI were characterized by small hippocampal volumes and elevated ratios of myo-inositol to creatine levels. Patients with naMCI on average had normal hippocampal volumes and 1H MRS metabolite ratios, but a greater proportion (3 of 20 patients [15%]) had cortical infarctions compared with patients with single-domain aMCI (6 of 91 [7%]). For characterization of MCI subtypes, 1H MRS and structural MRI findings were complementary. Conclusions: The MRI and 1H MRS findings in single-domain aMCI are consistent with a pattern similar to that of Alzheimer disease. Absence of this pattern on average in patients with naMCI suggests that cerebrovascular disease and other neurodegenerative diseases may be contributing to the cognitive impairment in many individuals with naMCI.

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