Identification of predictors for mini-mental state examination and revised Hasegawa's Dementia Scale scores using MR-based brain morphometry

Koji Yamashita,Takahiro Kuwashiro,Kensuke Ishikawa,Kiyomi Furuya,Shino Harada,Seitaro Shin,Noriaki Wada,Chika Hirakawa,Yasushi Okada,Tomoyuki Noguchi

doi:10.1016/j.ejro.2021.100359

Koji Yamashita, Takahiro Kuwashiro + Show 8 more

Open Access

https://doi.org/10.1016/j.ejro.2021.100359

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Abstract

PurposeThe early detection of cognitive function decline is crucial to help manage or slow the progression of symptoms. The Mini-Mental State Examination (MMSE) and revised Hasegawa's Dementia Scale (HDS-R) are widely used in screening for cognitive impairment. The purpose of this study was to explore common predictors of the two different cognitive testing systems using MR-based brain morphometry. Materials and MethodsThis retrospective study included 200 subjects with clinical suspicion of cognitive impairment who underwent 3D T1-weighted MRI at our institution between February 2019 and August 2020. Variables related to the volume of deep gray matter and 70 cortical thicknesses were obtained from the MR images using voxel-based specific regional analysis system for Alzheimer’s disease (VSRAD) and FreeSurfer software. The correlation between each variable including age and MMSE/HDS-R scores was evaluated using uni- and multi-variate logistic regression analyses. ResultsIn univariate analysis, parameters include hippocampal volume and bilateral entorhinal cortex (ERC) thickness showed moderate correlation coefficients with both MMSE and HDS-R scores. Multivariate analysis demonstrated the right ERC thickness was the common parameter which significantly correlates with both MMSE and HDS-R scores (p < 0.05). ConclusionRight ERC thickness appears to offer a useful predictive biomarker for both MMSE and HDS-R scores.

Highlights

Assessment of cognitive function in the elderly represents an essen tial step toward the detection of early-stage dementia
Right superior parietal lobe from FreeSurfer, and Z-score, percentage atrophy area in the voxel of interest (VOI) from VSRAD, and subject ages correlated significantly with Mini-Mental State Examination (MMSE) scores (Table 2)
Variables with moderate correlation coefficients (r > 0.3) were thicknesses of the right entorhinal cortex (ERC) and right insular cortex, volumes of the right amygdala and right, left and total hippo campi obtained from the FreeSurfer pipeline, Z-score and percentage atrophy area in the VOI computed from VSRAD

Summary

Introduction

Assessment of cognitive function in the elderly represents an essen tial step toward the detection of early-stage dementia. Subsequent early intervention could slow the progression of the disease. The Mini-Mental State Examination (MMSE) and revised Hasegawa’s Dementia Scale (HDS-R) are commonly used in screening for cognitive impairment [1]. MMSE reportedly provides reliable scores with no influence from repetition or learning, and consistent results from repeat testing by the same or different examiners [2]. HDS-R has been used in East-Asian countries [3,4] and may offer advantages over MMSE in that the scale could be administered to patients with motor impairment [3]. Never theless, MMSE and HDS-R have complementary roles for detecting cognitive impairment in routine clinical practice

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