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      Magnetic resonance imaging study cannot individually distinguish individuals with mild cognitive impairment, mild Alzheimer's disease, and normal aging Translated title: Estudo por ressonância magnética não pode diferenciar individualmente os indivíduos com declínio cognitivo leve, doença de Alzheimer leve e envelhecimento normal

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          Abstract

          Objective: To evaluate the volumetric and spectroscopy aspects of hippocampus in patients with mild Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods: A series of patients older than 65 years and with memory deficit were studied. Results: The evocation of words test presented a significant reduction in the number of words recalled by the patients with MCI and mild AD as compared with the control group. Bilateral reduction of the hippocampus volume in the AD group was observed when compared to the control group. There were no statistical differences in the values of NAA/Cr, mI/Cr, Cho/Cr and mI/NAA between the groups. Conclusions: Magnetic resonance imaging study failed to individually distinguish patients with MCI, mild AD and normal aging. However, patients with mild AD presented loss of asymmetry between the right and left hippocampus, and a reduction in hippocampus volume.

          Translated abstract

          Objetivo: Avaliar volume e espectroscopia do hipocampo em pacientes com doença de Alzheimer leve e declínio cognitivo leve. Métodos: Foi estudada uma série de pacientes com 65 anos de idade ou mais, com déficit de memória. Resultados: O teste de evocação de palavras mostrou redução significativa no número de palavras lembradas pelos pacientes com declínio cognitivo leve e doença de Alzheimer leve, em comparação com o grupo controle. Foi observada redução bilateral do volume do hipocampo no grupo com doença de Alzheimer quando comparado com o grupo controle. Não houve diferença estatística nos valores de NAA/Cr, mI/Cr, Cho/Cr e mI/NAA entre os grupos. Conclusão: Estudo pela ressonância magnética não diferencia individualmente os pacientes com declínio cognitivo leve, doença de Alzheimer leve e envelhecimento normal. No entanto, pacientes com quadro leve de doença de Alzheimer apresentam perda de assimetria entre os hipocampos direito e esquerdo e redução no volume do hipocampo.

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          Regional metabolic patterns in mild cognitive impairment and Alzheimer's disease: A 1H MRS study.

          Mild cognitive impairment (MCI) is a recently described transitional clinical state between normal aging and AD. Assuming that amnestic MCI patients had pathologic changes corresponding to an early phase and probable AD patients to a later phase of the disease progression, the authors could approximate the temporal course of proton MR spectroscopic (1H MRS) alterations in AD with a cross-sectional sampling scheme. The authors compared 1H MRS findings in the superior temporal lobe, posterior cingulate gyri, and medial occipital lobe in 21 patients with MCI, 21 patients with probable AD, and 63 elderly controls. These areas are known to be involved at different neurofibrillary pathologic stages of AD. The N-acetylaspartate (NAA)/creatine (Cr) ratios were significantly lower in AD patients compared to both MCI and normal control subjects in the left superior temporal and the posterior cingulate volumes of interest (VOI) and there were no between-group differences in the medial occipital VOI. Myoinositol (MI)/Cr ratios measured from the posterior cingulate VOI were significantly higher in both MCI and AD patients than controls. The choline (Cho)/Cr ratios measured from the posterior cingulate VOI were higher in AD patients compared to both MCI and control subjects. These findings suggest that the initial 1H MRS change in the pathologic progression of AD is an increase in MI/Cr. A decrease in NAA/Cr and an increase in Cho/Cr develop later in the disease course.
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            Clinical Dementia Rating (CDR).

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              Memory and MRI-based hippocampal volumes in aging and AD.

              To demonstrate structural-functional relationships between MRI-based volumetric measurements of medial temporal lobe structures and cognitive function. Previous work has documented the ability of MRI-based measurements of the hippocampus to discriminate between age-matched control subjects and patients with very mild AD. Relatively less is known about the correlation between medial temporal lobe structures and cognitive functions. We evaluated structural-functional relationships among the hippocampal formation, parahippocampal gyrus, and amygdala, and measures of memory, language, and general cognitive performance in 220 probable AD patients and normal control subjects. Standardized instruments of memory and general cognitive function were used to assess subjects enrolled in a longitudinal study of aging and dementia. The volume of the hippocampal formation predicted performance on most acquisition and recall measures across the spectrum of normal aging and AD. If the groups were segregated, most of the expected associations between medial temporal lobe structures and memory measures were observed in the AD patients. MRI-based hippocampal volumetry accurately depicts the structural-functional relationships between memory loss and hippocampal damage across the spectrum from normal aging to dementia.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                anp
                Arquivos de Neuro-Psiquiatria
                Arq. Neuro-Psiquiatr.
                Academia Brasileira de Neurologia - ABNEURO (São Paulo )
                1678-4227
                April 2013
                : 71
                : 4
                : 207-212
                Affiliations
                [1 ] Federal University of Pernambuco Brazil
                Article
                S0004-282X2013000400207
                10.1590/0004-282X20130003
                23588280
                071c6cd2-e320-4b07-846f-963d3a7f3358

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0004-282X&lng=en
                Categories
                NEUROSCIENCES
                PSYCHIATRY

                Neurosciences,Clinical Psychology & Psychiatry
                Alzheimer disease,dementia,mild cognitive impairment,hippocampus,magnetic resonance imaging,spectroscopy,doença de Alzheimer,demência,comprometimento cognitivo leve,hipocampo,ressonância magnética,espectroscopia

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