Adriaan Cornelis Gerardus Maria van Es MS, Presenter: Nothing to Disclose

Wiesje M. van der Flier PhD, Abstract Co-Author: Nothing to Disclose

Huub A. Middelkoop PhD, Abstract Co-Author: Nothing to Disclose

Faiza Admiraal-Behloul PhD, Abstract Co-Author: Nothing to Disclose

R. G. Westendorp PhD, Abstract Co-Author: Nothing to Disclose

Mark A van Buchem, Abstract Co-Author: Nothing to Disclose

A. W. Weverling-Rijnsburger PhD, Abstract Co-Author: Nothing to Disclose

Hans Olofsen MS, Abstract Co-Author: Nothing to Disclose

E. L. Bollen PhD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

There is growing evidence that Alzheimer's Disease (AD) results from a synergistic interaction between classical Alzheimer-type pathology that is confined to the gray matter (GM) and vascular pathology, mainly affecting the white matter (WM). In this study we asses 1) whether the global brain damage that has been detected previously in Mild Cognitive Impairment (MCI) and AD using Magnetization Transfer Imaging (MTI) is located in the GM or WM matter and 2) how MTI changes relate to volume changes in the same cerebral compartments.

Fifty-five patients with probable AD,19 patients with MCI and 48 participants with normal cognitive function were included. AD was diagnosed using the NINCDS/ADRDA-criteria. The criteria according to Petersen were used for the diagnosis of MCI. MRI was performed on a 1.5T system and conventional dual fast spin-echo and FLAIR sequences were obtained in all patients. In adition, MTI of the brain was performed using a 3D gradient-echo pulse sequence. SNIPER, in-house developed software, was used for image post processing. GM and WM were segmented on the PD scan. Cerebellum and brain stem were left out. The masks were then coregistered to the MT images and the Magnetization Transfer Ratio (MTR) histograms were generated for GM and WM seperately. P-values <0.01 were considered significant.

AD patients had significantly lower GM and parenchyma (PAR) volumes than controls. No significant differences in GM, WM, and PAR volume were observed between MCI patients on the one hand and either controls or AD patients on the other. However, normalized peak height (nPH) was significantly lower in MCI and AD than controls for GM and WM and consequently PAR. Structural integrity of the cerebral cortex, expressed in GM-nPH, was shown to correlate most strongly with cognition as measured by MMSE.

MT imaging is a powerful tool in detecting early ultrastructural changes in MCI patients even before volumetric changes become apparent. The observation that these changes were found in both GM and WM suggests that both classical Alzheimer-type pathology and vascular pathology are accumulating in the brain of MCI patients before they clinically convert to AD.

van Es, A, van der Flier, W, Middelkoop, H, Admiraal-Behloul, F, Westendorp, R, van Buchem, M, Weverling-Rijnsburger, A, Olofsen, H, Bollen, E, et al, , Magnetization Transfer Ratio of Gray and White Matter in Mild Cognitive Impairment and Alzheimer's Disease.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4413491.html