Evaluation of Early Cerebral Atrophy in Mild Cognitive Impairment with Positive Amyloid PET using MRIVolumetric Measurement

Objective: To identify early cerebral atrophy by using magnetic resonance imaging (MRI) volumetric measurement to distinguish mild cognitive impairment (MCI) from normal aging. Materials and Methods: A retrospective study in 29 Alzheimer’s disease (AD) patients (mean 75.6±7.3 years), 11 MCI patients (mean 68.8±3.9 years), and 27 healthy control (HC) subjects (mean 69.3±4.7 years) was performed with analysis of neurological and neuropsychiatric test, and underwent 3T MRI with high-resolution 3D-T1W. Quantitative volumetric analysis of brain including surface area, cortical gray matter volume, cortical thickness, and hippocampal subfields was performed by using FreeSurfer software. Results: The diminishment of cortical gray matter volume and cortical thickness were involved in most of brain regions, predominantly in temporal lobe with statistical significance in AD compared with MCI and HC. Comparison between amyloid positron emission tomography (PET) positive MCI subjects and HC has statistically significant difference in most regions of hippocampal subfield. The highest accuracy of 90.01% with sensitivity of 50% and specificity of 100% were found at subiculum. A comparison between amyloid PET positive MCI subjects and amyloid PET negative MCI subjects revealed significant differences at right molecular layer, right/average GC-ML-DG, right CA2/3, right CA4, and average CA4 with good accuracy, sensitivity, and specificity. Conclusion: The present study confirmed improved sensitivity of MRI volumetric measurement with hippocampal subfield analysis to identify early stage of AD in MCI patients, at least compared with positive amyloid PET MCI. Study with higher number of subjects using this method to discriminate MCI and normal aging control would provide benefits as the screening tool in older population. Keywords: Hippocampal subfield; Volumetric analysis; Alzheimer’s disease; Mild cognitive impairment DOI: doi.org/10.35755/jmedassocthai.2021.06.12427 Received 5 February 2021 | Revised 24 April 2021 | Accepted 28 April 2021