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Decarli C, Frisoni GB, Clark CM, Harvey D, Grundman M, Petersen RC, Thal LJ, Jin S, Jack CR, Scheltens P, . Qualitative estimates of medial temporal atrophy as a predictor of progression from mild cognitive impairment to dementia. Arch Neurol. 2007 Jan;64(1):108-15. PubMed.
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Dementia Reserch Center
This is an interesting and useful paper. It confirms in a large cohort
of MCI subjects that hippocampal atrophy is an important marker of
risk of progression to AD. More importantly, however, the authors show
that qualitative assessment using an easily applied visual rating
scale can be used to identify those at high risk of progression to
clinical AD—this is of more direct relevance to current clinical
practice than complicated manual (or other) measurements of
hippocampal volume. The implication is that MCI patients who do not
have an MRI or, having had an MRI, do not have their hippocampal
atrophy adequately evaluated, have not had their risk of progression to AD properly assessed.
University of Pennsylvania
This study advances efforts to define individuals with MCI at greatest risk for AD, and it will be important in follow-up studies that define the sensititivy, specificity, positive and negative predictive value of MTA measures for distinguishing who will/will not progress to AD or other dementing disorders.
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