Objectives: Posterior Cortical Atrophy (PCA) is an atypical presentation of Alzheimer disease (AD) characterized by atrophy of posterior brain regions. This pattern of atrophy is usually evaluated with Koedam visual rating scale, a score developed to enable visual assessment of parietal atrophy on magnetic resonance imaging (MRI). However, Koedam scale is complex to assess and its utility in the differential diagnosis between PCA and typical AD has not been demonstrated yet. The aim of this study is therefore to spot a simple and reliable MRI element able to differentiate between PCA and typical AD using visual rating scales. Methods: 15 patients who presented with progressive complex visual disorders and predominant occipitoparietal hypometabolism on PET-FDG were selected from our centre and compared with 30 typical AD patients and 15 healthy subjects. We used previously validated visual rating scales including Koedam scale, which we divided into three major components: posterior cingulate, precuneus and parieto-occipital. Subsequently we validated the results using the automated software Brainvisa Morphologist and Voxel Based Morphometry (VBM). Results: Patients with PCA, compared to typical AD, showed higher widening of the parieto-occipital sulcus, assessed both with visual rating scales and Brainvisa. In the corresponding areas, the VBM analysis showed an inverse correlation between the results obtained from the visual evaluation scales with the volume of the grey matter and a direct correlation between the same results with the cerebrospinal fluid volume. Conclusions: A visually based rating scale for parieto-occipital sulcus can distinguish Posterior Cortical Atrophy from typical Alzheimer disease.

Parieto-occipital sulcus widening differentiates posterior cortical atrophy from typical Alzheimer disease / G.G. Fumagalli, P. Basilico, A. Arighi, M. Mercurio, M. Scarioni, T. Carandini, A. Colombi, A.M. Pietroboni, L. Sacchi, G. Conte, E. Scola, F. Triulzi, E. Scarpini, D. Galimberti. - In: NEUROIMAGE. CLINICAL. - ISSN 2213-1582. - 28(2020). [10.1016/j.nicl.2020.102453]

Parieto-occipital sulcus widening differentiates posterior cortical atrophy from typical Alzheimer disease

G.G. Fumagalli
Primo
;
P. Basilico
Secondo
;
A. Arighi;M. Mercurio;M. Scarioni;T. Carandini;A.M. Pietroboni;G. Conte;F. Triulzi;E. Scarpini
Penultimo
;
D. Galimberti
Ultimo
2020

Abstract

Objectives: Posterior Cortical Atrophy (PCA) is an atypical presentation of Alzheimer disease (AD) characterized by atrophy of posterior brain regions. This pattern of atrophy is usually evaluated with Koedam visual rating scale, a score developed to enable visual assessment of parietal atrophy on magnetic resonance imaging (MRI). However, Koedam scale is complex to assess and its utility in the differential diagnosis between PCA and typical AD has not been demonstrated yet. The aim of this study is therefore to spot a simple and reliable MRI element able to differentiate between PCA and typical AD using visual rating scales. Methods: 15 patients who presented with progressive complex visual disorders and predominant occipitoparietal hypometabolism on PET-FDG were selected from our centre and compared with 30 typical AD patients and 15 healthy subjects. We used previously validated visual rating scales including Koedam scale, which we divided into three major components: posterior cingulate, precuneus and parieto-occipital. Subsequently we validated the results using the automated software Brainvisa Morphologist and Voxel Based Morphometry (VBM). Results: Patients with PCA, compared to typical AD, showed higher widening of the parieto-occipital sulcus, assessed both with visual rating scales and Brainvisa. In the corresponding areas, the VBM analysis showed an inverse correlation between the results obtained from the visual evaluation scales with the volume of the grey matter and a direct correlation between the same results with the cerebrospinal fluid volume. Conclusions: A visually based rating scale for parieto-occipital sulcus can distinguish Posterior Cortical Atrophy from typical Alzheimer disease.
Alzheimer Disease; Differential Diagnosis; Posterior Cortical Atrophy; Visual rating scale; Voxel based morphometry;
Settore MED/37 - Neuroradiologia
28-set-2020
Article (author)
File in questo prodotto:
File Dimensione Formato  
1-s2.0-S2213158220302904-main.pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 2.82 MB
Formato Adobe PDF
2.82 MB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/821465
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 2
  • ???jsp.display-item.citation.isi??? 2
social impact