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From the Departments of Diagnostic Radiology (Dr. Jack), Neurology (Dr. Petersen), Biostatistics (Dr. O'Brien), and Community Internal Medicine (Dr. Tangalos), Mayo Clinic and Mayo Foundation, Rochester, MN.
We evaluated a new magnetic resonance (MR)-based technique for performing volumetric measurements of temporal lobe structures. The technique was designed to assist in making the clinical diagnosis of dementia of the Alzheimer type (DAT). We chose specific anatomic regions of interest because of their known involvement in memory function and in the neuropathology of DAT and used a regression model to assess the effects of age on the volumes of the anterior temporal lobe (ATL) and the hippocampal formation (HF). These measurements were normalized by total intracranial volume (TIV). The volumetric measurements of both the normalized ATL and HF were significantly smaller (p < 0.001) in DAT patients (N = 20) than in controls (N = 22), but the HF volumes provided much better separation between the two groups. Eighty-five percent of the DAT patients fell below the range of the HF/TIV measurement for the control subjects. This separation held up over the entire age range studied. Normalized volumes of both the HF and ATL decreased with age significantly for both the DAT patients and the controls. These results support the contention that MR-based HF volumetric measurements are accurate in differentiating DAT patients from cognitively normal elderly individuals. This technique may be a useful adjunct in making the clinical diagnosis of DAT.
Address correspondence and reprint requests to Dr. Clifford R. Jack, Jr., Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905.
Supported in part by grants from the National Institute on Aging: AG06786, Mayo Clinic Alzheimer's Disease Patient Registry, and AG08031–01-CA, Mayo Clinic Alzheimer's Disease Core Center; and the Mayo Foundation.
Received April 2, 1991. Accepted for publication in final form July 2, 1991.
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J.C. Pruessner, L.M. Li, W. Serles, M. Pruessner, D.L. Collins, N. Kabani, S. Lupien, and A.C. Evans Volumetry of Hippocampus and Amygdala with High-resolution MRI and Three-dimensional Analysis Software: Minimizing the Discrepancies between Laboratories Cereb Cortex, April 1, 2000; 10(4): 433 - 442. [Abstract] [Full Text] [PDF]
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R. Barber, C. Ballard, I. G. McKeith, A. Gholkar, and J. T. O'Brien MRI volumetric study of dementia with Lewy bodies: A comparison with AD and vascular dementia Neurology, March 28, 2000; 54(6): 1304 - 1309. [Abstract] [Full Text] [PDF]
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R. C. Petersen, C. R. Jack Jr., Y.-C. Xu, S. C. Waring, P. C. O'Brien, G. E. Smith, R. J. Ivnik, E. G. Tangalos, B. F. Boeve, and E. Kokmen Memory and MRI-based hippocampal volumes in aging and AD Neurology, February 8, 2000; 54(3): 581 - 581. [Abstract] [Full Text] [PDF]
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R. Jenkins, N. C. Fox, A. M. Rossor, R. J. Harvey, and M. N. Rossor Intracranial Volume and Alzheimer Disease: Evidence Against the Cerebral Reserve Hypothesis Arch Neurol, February 1, 2000; 57(2): 220 - 224. [Abstract] [Full Text] [PDF]
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M. Narayan, J. D. Bremner, and A. Kumar Neuroanatomic Substrates of Late-Life Mental Disorders J Geriatr Psychiatry Neurol, October 1, 1999; 12(3): 95 - 106. [Abstract] [PDF]
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Y. Tanaka, Y. Miyazawa, R. Hashimoto, I. Nakano, and T. Obayashi Postencephalitic focal retrograde amnesia after bilateral anterior temporal lobe damage Neurology, July 1, 1999; 53(2): 344 - 344. [Abstract] [Full Text] [PDF]
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V. A. Magnotta, D. Heckel, N. C. Andreasen, T. Cizadlo, P. W. Corson, J. C. Ehrhardt, and W. T. C. Yuh Measurement of Brain Structures with Artificial Neural Networks: Two- and Three-dimensional Applications Radiology, June 1, 1999; 211(3): 781 - 790. [Abstract] [Full Text]
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H. Utsunomiya, K. Takano, M. Okazaki, and A. Mitsudome Development of the Temporal Lobe in Infants and Children: Analysis by MR-Based Volumetry AJNR Am. J. Neuroradiol., April 1, 1999; 20(4): 717 - 723. [Abstract] [Full Text]
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J. A. Harasty, G. M. Halliday, J. J. Kril, and C. Code Specific temporoparietal gyral atrophy reflects the pattern of language dissolution in Alzheimer's disease Brain, April 1, 1999; 122(4): 675 - 686. [Abstract] [Full Text] [PDF]
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C. R. Jack Jr., R. C. Petersen, Y. C. Xu, P. C. O'Brien, G. E. Smith, R. J. Ivnik, B. F. Boeve, S. C. Waring, E. G. Tangalos, and E. Kokmen Prediction of AD with MRI-based hippocampal volume in mild cognitive impairment Neurology, April 1, 1999; 52(7): 1397 - 1397. [Abstract] [Full Text] [PDF]
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Q. Mu, J. Xie, Z. Wen, Y. Weng, and Z. Shuyun A Quantitative MR Study of the Hippocampal Formation, the Amygdala, and the Temporal Horn of the Lateral Ventricle in Healthy Subjects 40 to 90 Years of Age AJNR Am. J. Neuroradiol., February 1, 1999; 20(2): 207 - 211. [Abstract] [Full Text]
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K. Juottonen, M. P. Laakso, K. Partanen, and H. Soininen Comparative MR Analysis of the Entorhinal Cortex and Hippocampus in Diagnosing Alzheimer Disease AJNR Am. J. Neuroradiol., January 1, 1999; 20(1): 139 - 144. [Abstract] [Full Text]
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G. B. Frisoni, M. P. Laakso, A. Beltramello, C. Geroldi, A. Bianchetti, H. Soininen, and M. Trabucchi Hippocampal and entorhinal cortex atrophy in frontotemporal dementia and Alzheimer's disease Neurology, January 1, 1999; 52(1): 91 - 91. [Abstract] [Full Text] [PDF]
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K Juottonen, M Lehtovirta, S Helisalmi, P J R. Sr, and H Soininen Major decrease in the volume of the entorhinal cortex in patients with Alzheimer's disease carrying the apolipoprotein E epsilon 4 allele J. Neurol. Neurosurg. Psychiatry, September 1, 1998; 65(3): 322 - 327. [Abstract] [Full Text]
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C. Watson, C. R. Jack Jr, and F. Cendes Volumetric Magnetic Resonance Imaging: Clinical Applications and Contributions to the Understanding of Temporal Lobe Epilepsy Arch Neurol, December 1, 1997; 54(12): 1521 - 1531. [Abstract] [PDF]
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 M. J. de Leon, T. McRae, H. Rusinek, A. Convit, S. De Santi, C. Tarshish, J. Golomb, N. Volkow, K. Daisley, N. Orentreich, et al. Cortisol Reduces Hippocampal Glucose Metabolism in Normal Elderly, but Not in Alzheimer's Disease J. Clin. Endocrinol. Metab., October 1, 1997; 82(10): 3251 - 3259. [Abstract] [Full Text] [PDF]
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E. Mori, Y. Yoneda, H. Yamashita, N. Hirono, M. Ikeda, and A. Yamadori Medial temporal structures relate to memory impairment in Alzheimer's disease: an MRI volumetric study J. Neurol. Neurosurg. Psychiatry, August 1, 1997; 63(2): 214 - 221. [Abstract] [Full Text] [PDF]
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 T. L. Strassburger, H.-C. Lee, E. M. Daly, J. Szczepanik, J. S. Krasuski, M. J. Mentis, J. A. Salerno, C. DeCarli, M. B. Schapiro, and G. E. Alexander Interactive Effects of Age and Hypertension on Volumes of Brain Structures Stroke, July 1, 1997; 28(7): 1410 - 1417. [Abstract] [Full Text]
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R. Fama, E. V. Sullivan, P. K. Shear, L. Marsh, J. A. Yesavage, J. R. Tinklenberg, K. O. Lim, and A. Pfefferbaum Selective Cortical and Hippocampal Volume Correlates of Mattis Dementia Rating Scale in Alzheimer Disease Arch Neurol, June 1, 1997; 54(6): 719 - 728. [Abstract] [PDF]
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V. P. Prasher, P. C. Barber, R. West, and P. Glenholmes The Role of Magnetic Resonance Imaging in the Diagnosis of Alzheimer Disease in Adults With Down Syndrome Arch Neurol, December 1, 1996; 53(12): 1310 - 1313. [Abstract] [PDF]
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 R. C. Petersen, G. E. Smith, R. J. Ivnik, E. G. Tangalos, D. J. Schaid, S. N. Thibodeau, E. Kokmen, S. C. Waring, and L. T. Kurland Apolipoprotein E Status as a Predictor of the Development of Alzheimer's Disease in Memory-Impaired Individuals JAMA, April 26, 1995; 273(16): 1274 - 1278. [Abstract] [PDF]
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P. K. Shear, E. V. Sullivan, D. H. Mathalon, K. O. Lim, L. F. Davis, J. A. Yesavage, J. R. Tinklenberg, and A. Pfefferbaum Longitudinal Volumetric Computed Tomographic Analysis of Regional Brain Changes in Normal Aging and Alzheimer's Disease Arch Neurol, April 1, 1995; 52(4): 392 - 402. [Abstract] [PDF]
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