Relationship between MTA visual scale scores and hippocampal volume measured by a medical device in patients from a multicentric memory clinic population

Abstract

AbstractBackgroundThe medial temporal lobe (MTL), including the hippocampus, undergoes atrophy in patients with Alzheimer’s disease (AD). Visual rating of medial temporal lobe atrophy (MTA) is often performed in the assessment of patients with cognitive impairment. Calculation of hippocampal volumes (HV) can also be achieved by multiple automated and semi‐automated methods using T1‐weighted MR images. The current study investigated the relationship between HV and z‐scores calculated by an automated method, included in the QyScore® medical device, and visual MTA rating scores using Scheltens’ scale in a multicentric memory clinic population at baseline.Method1959 participants from the MEMENTO cohort (Age 71.02 +/‐ 8.61, 1218 Female, MMSE 27.95 +/‐ 1.91) had 3DT1 MRI scans analyzed with QyScore®, an FDA‐approved and CE‐marked image analysis software. HV are reported in mL, corrected for % Intra Cranial Volume (ICV), and in z‐scores calculated relative to a cognitively normal population. 814 had amyloid status from CSF or PET, of which 216 were Amyloid+. Correlation between MTA scores and quantitative HV measurements was ascertained by Spearman’s rank correlation.ResultThere was a significant negative correlation between MTA scores and HV in %ICV (Left ‐0.62, p<0.001; Right ‐0.59, p<0.001) and z‐scores (Left ‐0.47, p<0.001; Right ‐0.43 p<0.001) for the total sample, as well as in Amyloid+ individuals HV in %ICV (Left ‐0.63 p<0.001, Right ‐0.58 p<0.001) and z‐scores (Left ‐0.50 p<0.001, Right ‐0.47 p<0.001). The correlation was also strong when separated by clinical diagnosis: patients with Subjective Cognitive Complaint (SCC, N = 306, AGE: 69.82 +/‐ 8.03, 196 female, MMSE: 28.86 +/‐ 1.17) and MCI (N = 1646, Age: 71.23 +/‐ 8.71, 1018 Female, MMSE: 27.79 +/‐ 1.95) presented MTA scores correlated both with HV in %ICV (Right = ‐0.47 p<0.001, Left = ‐0.50 p<0.001 for SCC; Right = ‐0.60 p<0.001, Left = ‐0.63 p<0.001 for MCI) and z‐scores (Right = ‐0.26 p<0.001, Left = ‐0.33 p<0.001 for SCC; Right = 0.44 p<0.001, Left = ‐0.49 p<0.001 for MCI).ConclusionThe automated quantification of ICV‐corrected HV and z‐scores were well‐correlated to MTA scores. QyScore® z‐scores may improve specificity in patients with cognitive impairment, by providing automated quantification of hippocampal atrophy directly compared with healthy ageing.