New procedure to measure brain atrophy can predict decline in MCI patients

Many patients with mild cognitive impairment - a transitional stage between the "forgetfulness" associated with normal aging and Alzheimer's disease - never decline into the more serious neuro-degenerative disease. As a result, physicians need to be able to objectively measure which of their patients will clinically decline, ensuring that treatment targeted to prevent or slow down neuro-degeneration is used appropriately.

To support this goal, researchers at the Memory Disorders Clinic at UC San Diego Medical Center have, for over a year, successfully used a fully automated procedure called Volumetric MRI, which acquires images from an MRI scanner and translates them into quantitative values. "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," says co-author Michael Rafii, M.D., Ph.D., 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."

Their study evaluated fully automated volume measures of 269 MCI patients over a six-month period. Baseline volume measurements of the hippocampus, amygdala and temporal horn were evaluated as predictors of cognitive change. Two commonly used instruments for screening cognitive function and dementia were used to make the measurements. Patients with smaller volumes of the hippocampus and amygdala showed more rapid clinical decline on these tests. The study has been published in the June issue of Alzheimer Disease and Associated Disorders.

UC San Diego was the first clinic site to use this technology, which is now beginning to take hold in other clinical settings across the country to measure brain atrophy. "Use of this procedure is like bringing the experience of an expert neuro-radiologist to any clinic that has the right software," says James Brewer, M.D., Ph.D., 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."

News Release: Measuring brain atrophy in patients with mild cognitive impairment     www.sciencedaily.com     June 16, 2009