Journal of the International Neuropsychological Society

Research Articles

Entorhinal cortex volume in older adults: Reliability and validity considerations for three published measurement protocols

C.C. PRICEa1a2a3 c1, M.F. WOODa4, C.M. LEONARDa2a5, S. TOWLERa1, J. WARDa1, H. MONTIJOa6, I. KELLISONa1, D. BOWERSa1a2, T. MONKa7, J.C. NEWCOMERa8 and I. SCHMALFUSSa9a10

a1 Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida

a2 McKnight Brain Institute, University of Florida, Gainesville, Florida

a3 Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, Florida

a4 College of Medicine, University of Florida, Gainesville, Florida

a5 Department of Neuroscience, College of Medicine, University of Florida, Gainesville, Florida

a6 Duke University School of Medicine, Durham, North Carolina

a7 Department of Anesthesiology, Duke University, Durham, North Carolina

a8 Department of Psychiatry, Washington University, St. Louis, Missouri

a9 Department of Radiology, College of Medicine, University of Florida, Gainesville, Florida

a10 Department of Radiology, North Florida South Georgia Veteran Administration, Gainesville, Florida

Abstract

Measuring the entorhinal cortex (ERC) is challenging due to lateral border discrimination from the perirhinal cortex. From a sample of 39 nondemented older adults who completed volumetric image scans and verbal memory indices, we examined reliability and validity concerns for three ERC protocols with different lateral boundary guidelines (i.e., Goncharova, Dickerson, Stoub, & deToledo-Morrell, 2001; Honeycutt et al., 1998; Insausti et al., 1998). We used three novice raters to assess inter-rater reliability on a subset of scans (216 total ERCs), with the entire dataset measured by one rater with strong intra-rater reliability on each technique (234 total ERCs). We found moderate to strong inter-rater reliability for two techniques with consistent ERC lateral boundary endpoints (Goncharova, Honeycutt), with negligible to moderate reliability for the technique requiring consideration of collateral sulcal depth (Insausti). Left ERC and story memory associations were moderate and positive for two techniques designed to exclude the perirhinal cortex (Insausti, Goncharova), with the Insausti technique continuing to explain 10% of memory score variance after additionally controlling for depression symptom severity. Right ERC-story memory associations were nonexistent after excluding an outlier. Researchers are encouraged to consider challenges of rater training for ERC techniques and how lateral boundary endpoints may impact structure-function associations. (JINS, 2010, 16, 846–855.)

(Received July 02 2009)

(Reviewed June 04 2010)

(Accepted June 04 2010)

Correspondence:

c1 Correspondence and reprint requests to: Catherine C. Price, Ph.D., Clinical and Health Psychology, 101 S. Newell Drive, PO Box 100165, University of Florida, Gainesville, FL 32610. E-mail: cep23@phhp.ufl.edu

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