Visual atrophy rating scales and amyloid PET status in an Alzheimer's disease clinical cohort
Abstract Objectives Visual rating scales (VRS) are the quantification method closest to the approach used in routine clinical practice to assess brain atrophy. Previous studies have suggested that the medial temporal atrophy (MTA) rating scale is a reliable diagnostic marker for AD, equivalent to vo...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-04-01
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| Series: | Annals of Clinical and Translational Neurology |
| Online Access: | https://doi.org/10.1002/acn3.51749 |
| _version_ | 1797845281014808576 |
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| author | Flavia Loreto Anastassia Gontsarova Gregory Scott Neva Patel Zarni Win Christopher Carswell Richard Perry Paresh Malhotra |
| author_facet | Flavia Loreto Anastassia Gontsarova Gregory Scott Neva Patel Zarni Win Christopher Carswell Richard Perry Paresh Malhotra |
| author_sort | Flavia Loreto |
| collection | DOAJ |
| description | Abstract Objectives Visual rating scales (VRS) are the quantification method closest to the approach used in routine clinical practice to assess brain atrophy. Previous studies have suggested that the medial temporal atrophy (MTA) rating scale is a reliable diagnostic marker for AD, equivalent to volumetric quantification, while others propose a higher diagnostic utility for the Posterior Atrophy (PA) scale in early‐onset AD. Methods Here, we reviewed 14 studies that assessed the diagnostic accuracy of PA and MTA, we explored the issue of cut‐off heterogeneity, and assessed 9 rating scales in a group of patients with biomarker‐confirmed diagnosis. A neuroradiologist blinded to all clinical information rated the MR images of 39 amyloid‐positive and 38 amyloid‐negative patients using 9 validated VRS assessing multiple brain regions. Automated volumetric analyses were performed on a subset of patients (n = 48) and on a group of cognitively normal individuals (n = 28). Results No single VRS could differentiate amyloid‐positive from amyloid‐negative patients with other neurodegenerative conditions. 44% of amyloid‐positive patients were deemed to have age‐appropriate levels of MTA. In the amyloid‐positive group, 18% had no abnormal MTA or PA scores. These findings were substantially affected by cut‐off selection. Amyloid‐positive and amyloid‐negative patients had comparable hippocampal and parietal volumes, and MTA but not PA scores correlated with the respective volumetric measures. Interpretation Consensus guidelines are needed before VRS can be recommended for use in the diagnostic workup of AD. Our data are suggestive of high intragroup variability and non‐superiority of volumetric quantification of atrophy over visual assessment. |
| first_indexed | 2024-04-09T17:36:28Z |
| format | Article |
| id | doaj.art-a25b0c86b1f6495bb0d38cbc2a4df5d9 |
| institution | Directory Open Access Journal |
| issn | 2328-9503 |
| language | English |
| last_indexed | 2024-04-09T17:36:28Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Clinical and Translational Neurology |
| spelling | doaj.art-a25b0c86b1f6495bb0d38cbc2a4df5d92023-04-17T16:16:03ZengWileyAnnals of Clinical and Translational Neurology2328-95032023-04-0110461963110.1002/acn3.51749Visual atrophy rating scales and amyloid PET status in an Alzheimer's disease clinical cohortFlavia Loreto0Anastassia Gontsarova1Gregory Scott2Neva Patel3Zarni Win4Christopher Carswell5Richard Perry6Paresh Malhotra7Department of Brain Sciences Faculty of Medicine, Imperial College London London UKDepartment of Neuroradiology Imperial College Healthcare NHS Trust London UKDepartment of Brain Sciences Faculty of Medicine, Imperial College London London UKDepartment of Nuclear Medicine Imperial College Healthcare NHS Trust London UKDepartment of Nuclear Medicine Imperial College Healthcare NHS Trust London UKDepartment of Neurology Imperial College Healthcare NHS Trust London UKDepartment of Brain Sciences Faculty of Medicine, Imperial College London London UKDepartment of Brain Sciences Faculty of Medicine, Imperial College London London UKAbstract Objectives Visual rating scales (VRS) are the quantification method closest to the approach used in routine clinical practice to assess brain atrophy. Previous studies have suggested that the medial temporal atrophy (MTA) rating scale is a reliable diagnostic marker for AD, equivalent to volumetric quantification, while others propose a higher diagnostic utility for the Posterior Atrophy (PA) scale in early‐onset AD. Methods Here, we reviewed 14 studies that assessed the diagnostic accuracy of PA and MTA, we explored the issue of cut‐off heterogeneity, and assessed 9 rating scales in a group of patients with biomarker‐confirmed diagnosis. A neuroradiologist blinded to all clinical information rated the MR images of 39 amyloid‐positive and 38 amyloid‐negative patients using 9 validated VRS assessing multiple brain regions. Automated volumetric analyses were performed on a subset of patients (n = 48) and on a group of cognitively normal individuals (n = 28). Results No single VRS could differentiate amyloid‐positive from amyloid‐negative patients with other neurodegenerative conditions. 44% of amyloid‐positive patients were deemed to have age‐appropriate levels of MTA. In the amyloid‐positive group, 18% had no abnormal MTA or PA scores. These findings were substantially affected by cut‐off selection. Amyloid‐positive and amyloid‐negative patients had comparable hippocampal and parietal volumes, and MTA but not PA scores correlated with the respective volumetric measures. Interpretation Consensus guidelines are needed before VRS can be recommended for use in the diagnostic workup of AD. Our data are suggestive of high intragroup variability and non‐superiority of volumetric quantification of atrophy over visual assessment.https://doi.org/10.1002/acn3.51749 |
| spellingShingle | Flavia Loreto Anastassia Gontsarova Gregory Scott Neva Patel Zarni Win Christopher Carswell Richard Perry Paresh Malhotra Visual atrophy rating scales and amyloid PET status in an Alzheimer's disease clinical cohort Annals of Clinical and Translational Neurology |
| title | Visual atrophy rating scales and amyloid PET status in an Alzheimer's disease clinical cohort |
| title_full | Visual atrophy rating scales and amyloid PET status in an Alzheimer's disease clinical cohort |
| title_fullStr | Visual atrophy rating scales and amyloid PET status in an Alzheimer's disease clinical cohort |
| title_full_unstemmed | Visual atrophy rating scales and amyloid PET status in an Alzheimer's disease clinical cohort |
| title_short | Visual atrophy rating scales and amyloid PET status in an Alzheimer's disease clinical cohort |
| title_sort | visual atrophy rating scales and amyloid pet status in an alzheimer s disease clinical cohort |
| url | https://doi.org/10.1002/acn3.51749 |
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