MRI Helps Radiologists Predict Future Memory Decline

"We identified progressive brain atrophy as predictive of future cognitive decline among healthy elderly patients," said the study's lead author, Henry Rusinek, Ph.D., associate professor of radiology at New York University (NYU) School of Medicine in New York City.

"We have also shown that looking at the medial temporal lobe, a specific, relatively small brain region, was much more informative than looking at the whole brain," said Dr. Rusinek. The medial temporal lobe is a region near the middle of the brain that includes areas critical to forming new memories.

The researchers studied 45 healthy patients older than 60 to determine if medial temporal lobe atrophy rate predicted future memory decline. The patients underwent MR exams and neurological tests at the beginning of the study and two or more follow-up exams over a six-year period. The images and test results were compared and assessed for changes over time.

Of the 45 patients, 13 (29 percent) demonstrated cognitive decline. Medial temporal lobe atrophy rate was the most significant predictor of decline with overall accuracy of 89 percent.

"This study uses a novel approach to examine longitudinal changes in the brain, which are less subject to bias than existing approaches and are highly reproducible," said co-author Mony J. de Leon, Ed.D, professor of psychiatry and director of the Center for Brain Health at NYU School of Medicine.

The first signs of memory loss are usually diagnosed as mild cognitive impairment. People with mild cognitive impairment decline to dementia at a rate of 10 percent to 15 percent annually, compared with 1 percent to 2 percent among healthy elderly individuals. Accurate and early recognition of changes in the atrophy rate could enable therapy, as well as better tracking of the progression of decline.

"I do not believe that serious memory loss is a natural consequence of aging. A vast majority of elderly we see are very sharp and creative," Dr. Rusinek said. He advises those at risk for memory decline to exercise the brain as well as the body.

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Radiology is a monthly scientific journal devoted to clinical radiology and allied sciences. The journal is edited by Anthony V. Proto, M.D., School of Medicine, Virginia Commonwealth University, Richmond, Virginia. Radiology is owned and published by the Radiological Society of North America Inc. (http://radiology.rsnajnls.org).

The Radiological Society of North America (RSNA) is an association of more than 35,000 radiologists, radiation oncologists and related scientists committed to promoting excellence in radiology through education and by fostering research, with the ultimate goal of improving patient care. The Society is based in Oak Brook, Ill. (http://www.rsna.org).

"Regional Brain Atrophy Rate Predicts Future Cognitive Decline." Collaborating with Drs. Rusinek and de Leon on this study were Susan DeSanti, Ph.D., Dina Frid, B.S., Wai-Hon Tsui, M.S., Chaim Y. Tarshish, A.B.D., and Antonio Convit, M.D.