Psychological Medicine



Quantitative magnetic resonance imaging and neuropsychological functions in dementia of the Alzheimer type


J. PANTEL a1, J. SCHRÖDER a1, L. R. SCHAD a1, M. FRIEDLINGER a1, M. V. KNOPP a1, R. SCHMITT a1, M. GEISSLER a1, S. BLÜML a1, M. ESSIG a1 and H. SAUER a1
a1 Section of Geriatric Psychiatry, Department of Psychiatry, University of Heidelberg; Department of Radiology, German Centre of Cancer Research (DKFZ), Heidelberg; and Department of Psychiatry, University of Jena, Germany

Abstract

Background. The aim of the present study was to investigate neuropsychological functions in dementia of the Alzheimer type (DAT) with respect to morphological changes that were revealed by quantitative magnetic resonance imaging (MRI).

Methods. Twenty patients with DAT (NINCDS-ADRDA criteria) and 10 healthy age and sex matched controls were included. The neuropsychological function was evaluated on a test battery covering the severity of dementia, verbal and visual memory, concentration and attention, language skills and general intelligence as well as activities of daily living. 3D MRI sequences were acquired using a 1.5 T Siemens MAGNETOM. Whole brain volume, total intracranial volume (TIV), volume of the frontal and temporal lobes and volumes of the amygdalahippocampus complex (AHC) were assessed using the newly developed software NMRWin.

Results. Apart from TIV all morphometric parameters differed significantly between the diagnostic groups. AHC volumes discriminated best between the groups, with only a small overlap. AHC atrophy exceeded generalized atrophy. These findings were confirmed when the data were reanalysed after dividing the DAT patients into a mildly and moderately affected group. The severity of dementia was significantly correlated with the volumes of the AHC and the volumes of the temporal lobes bilaterally, but not with the whole brain volume and the volumes of the frontal lobes.

Conclusions. These results underline the important role of the temporal substructures for aetiology and progression of DAT. They indicate that the volume of the AHC can be monitored by MRI and may be used to follow up the disease process.


Correspondence:
Address for correspondence: Dr Johannes Pantel, Department of Psychiatry, University of Heidelberg, Vossstrasse 4, 69115 Heidelberg, Germany.


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