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Measuring Brain Atrophy in Patients with Mild Cognitive Impairment

Scientists at the University of California, San Diego (UCSD) School of Medicine have shown that a fully automated procedure called Volumetric MRI - which measures the "memory centers" of the brain and compares them to expected size - is effective in predicting the progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD).

"Use of this procedure is like bringing the experience of an expert neuroradiologist to any clinic that has the right software," said James Brewer, MD, PhD, assistant professor in UCSD's Departments of Radiology and Neurosciences. "These fully automated and rapid methods of measuring medial temporal lobe volumes may help clinicians predict cognitive decline in their patients and have the potential to influence how neurology is practiced."

MCI is considered a transitional stage between the forgetfulness associated with normal aging and AD. Yet, many patients with MCI do not progress to Alzheimer's, and these individuals do not need treatments targeted to prevent or slow down neurodegeneration. Therefore, objective measures are necessary to distinguish MCI patients who will clinically decline from those who will remain stable.

"Our goal was to find neuroimaging measures of change that reflected more than merely a person’s advancing age but instead correlated tightly with how a person's cognitive status worsens over time," said co-author Michael Rafii, MD, PhD, assistant professor of neurosciences at UCSD. "It's too early to draw a definitive comparison, but it appears that these early changes - especially shrinking of the hippocampus - may offer a robust biological marker for change."

The study, part of the Alzheimer Disease Neuroimaging Initiative, the largest AD study ever funded by the National Institutes of Health, is being conducted at 59 research centers in the U.S. and Canada; 821 volunteers are being followed for three years.