Assessing the onset of structural change in familial Alzheimer's disease
Jonathan M. SchottNick C. FoxChris FrostRachael I. ScahillJohn C. JanssenDennis ChanRhian JenkinsMartin N. Rossor
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Abstract Regional and global cerebral atrophy are inevitable features of Alzheimer's disease (AD). We assessed volumes and atrophy rates of brain structures in patients with familial AD during the period that they developed symptoms. Five patients with presymptomatic AD and 20 controls had two or more annual volumetric MRI brain scans. Volumes of brain, ventricles, temporal lobes, hippocampi, and entorhinal cortices (ECs) were measured. Rates of volume change were calculated from serial scans. There were no significant differences in baseline measures of whole brain, temporal lobe, or ventricular volume between patients and controls; averaged volumes of medial temporal lobe structures (both hippocampi and ECs) were 16.6% (95% confidence interval [CI], 3.3–28.0%) lower in patients. Atrophy rates for brain, temporal lobe, hippocampus, and EC were significantly increased in patients compared with controls ( p < 0.05). Averaged atrophy rates from both hippocampi and ECs were 5.1% (95% CI, 3.0–7.1%) greater in patients than controls. Linear extrapolation backward suggested medial temporal lobe atrophy commenced 3.5 years (95% CI, 0.7–7.5 years) before onset, when all patients were asymptomatic. We conclude that increased medial temporal lobe atrophy rates are an early and distinguishing feature of AD and that pathological atrophy probably is occurring several years before the onset of symptoms. Ann Neurol 2003;53:000–000Keywords:
Cerebral atrophy
A study of 50 alcoholic patients was carried out with CT scans of their brains and psychologic testing. These patients were alcohol and drug free, and without neurologic or psychiatric disorders at the time of the examinations. Fifty‐eight percent of the patients had cerebral atrophy. There was no correlation between the results of the psychologic testing and cerebral atrophy. The only factor that correlated to a significant degree with cerebral atrophy was the duration of problem drinking. Only the mean duration of problem drinking was statistically significantly longer in the patients with cerebral atrophy compared to those patients with normal CT scans. Implications of this finding of high prevalence of cerebral atrophy in alcoholics is discussed.
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Multiple sclerosis (MS) has traditionally been considered to be primarily an inflammatory demyelinating disorder affecting the white matter. Nowadays it is recognized as both an inflammatory and a neurodegenerative condition involving the white and grey matter. Grey matter atrophy occurs in the earliest stages of MS, progresses faster than in healthy individuals, and shows significant correlations with cognitive function and physical disability; indeed, brain atrophy is the best predictor of subsequent disability and can be measured using magnetic resonance imaging (MRI). There are a number of MRI methods for measuring global or regional brain volume, including cross-sectional and longitudinal techniques. Preventing brain volume loss may therefore have important clinical implications affecting treatment decisions, with several clinical trials now demonstrating an effect of disease-modifying treatments (DMTs) on reducing brain volume loss. In clinical practice, it may therefore be important to consider the potential impact of a therapy on reducing the rate of brain volume loss. This article summarizes the knowledge on brain volume in MS.
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Abstract We studied 74 consecutive patients with temporal lobe epilepsy who were treated surgically and in whom the volumes of mesial temporal structures were determined preoperatively by magnetic resonance imaging. We divided the patients into three groups according to the volumetric findings: unilateral (63.5% of the patients), bilateral (23%), or no atrophy (13.5%) of the amygdala–hippocampal formation. Two distinct surgical approaches were used: selective amygdalohippocampectomy (n = 37) or anterior temporal lobe resection (n = 37). Outcome was assessed at least 1 year after surgery, according to Engel's modified classification. Patients with unilateral mesial temporal atrophy had significantly better results compared with the other two groups ( p < 0.001): We found excellent results (class I or II outcome) in 93.6% of the patients with unilateral atrophy, in 61.7% of those with bilateral atrophy, and in 50% of the group with no significant atrophy of mesial temporal structures. The two different surgical techniques were equally effective, regardless of the pattern of atrophy. In conclusion, magnetic resonance volumetric studies in temporal lobe epilepsy proved to be an important preoperative prognostic tool for surgical treatment, but they did not provide guidance for selecting one surgical approach compared to the other.
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Computed tomography scans of 15 long-term steroid users showed varying degrees of apparent cerebral atrophy, not expected at their ages (8 to 40 years). Most were suffering from autoimmune diseases. There appeared to be some correlation between dosage and degree of apparent atrophy. There was surprisingly little clinical evidence of cerebral dysfunction associated with this apparent atrophy. In two of the cases, the appearance of the brain improved following decrease or cessation of steroid use. Speculations are made on possible causes.
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Objective To analyze CT image of cerebral atrophy after brain impairment in children.Methods Clinical and CT data of 46 children with different degree cerebral atrophy after brain impairment were collected and analyzed.Results Through the CT image,there were 15 cases of diffuse cerebral atrophy,31cases of circumscribed cerebral atrophy,19 cases of peripheral cerebral atrophy and 27 cases of central cerebral atrophy.19 cases were HIE of newborn,10 cases ware sequelae of congenital intrauterine infection,5 cases were diagnosed as viral encephalitis,hemorrhage due to delayed HDN and cerebral trauma each were 3 cases,4 cases were cerebral vasculer malformation and 2 cases were caused by others.Conclusion Cerebral atrophy is a frequent CT image after brain injured in children.Misdiagnosis and missed diagnosis would not happen by carefully analysing the CT image and the clinical data.
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The loss of parenchymal brain volume per normative age comparison is a distinctive feature of brain atrophy. While the condition is the most prevalent to elderly, it has also been observed in pediatric ages. Various causes such as trauma, infection, and malnutrition have been reported to trigger the loss of brain tissues volume. Despite this literature based knowledge of risk factors, the magnitude of brain atrophy in pediatric age group is scantly addressed in most developing countries including Tanzania. The current study aims to understand the magnitude of brain atrophy in children residing in Northern Zone, Tanzania.A cross-sectional hospital survey was performed in which 455 children who were presented with various brain pathologies from the year 2013 to 2019 and whose brains examined by Computerized tomography (CT)-Scanners were recruited in the study. The brain statuses were examined using three linear radiological methods including the measure of sulcal-width, Evans index, and lateral ventricular body width.Results showed a significant number of atrophied brains among children in Northern Tanzania and that the condition was observed to have a 1:1 male to female ratio. The prevalence of pediatric brain atrophy was found to be 16.04%.The cortical subtype of brain atrophy presented as the most prevalent type of brain volume loss. The findings of this study suggest existence of considerable trends of brain atrophy in children which need special attention and mitigation plans.
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Objective To analyse CT image of cerebral atrophy after brain impairment in children.Methods To collect and analyze the clinical and CT data of 46 children with different degree cerebral atrophy after brain impairment in a hospital of Zhengzhou.Results Through the CT image,in all the cases,there are 15 cases of diffuse cerebral atrophy,31cases of circumscribed cerebral atrophy,19 cases of peripheral cerebral atrophy and 27 cases of central cerebral atrophy.From the clinical data,19 cases are HIE of newborn,10 cases are sequelae of congenital intrauterine infection,5 cases are diagnosed as viral encephalitis,Hemorrhage due to delayed HDN and cerebral trauma each are 3 cases,4 cases are cerebral vasculer malformation and 2 cases are caused by others.Conclusion Cerebral atrophy is a frequent CT image after brain injured in children.Misdiagnosis and missed diagnosis would not happen by carefully analysing the CT image and the clinical data.
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The relation of brain atrophy measured with computed tomography (CT) to mental deterioration on living people was studied. A newly improved technique for quantitative measurement of brain atrophy was developed. The pixels inside the head slices were divided into three parts; brain skull, and cerebrospinal fluid according to their CT number. The volume of brain, CSF, and cranial cavity were calculated by counting the number of pixels of each tissue. Results from 130 normal brains showed that the CSF volume was constant at about 16 ml through 20--39 years old. After 40 years the mean CSF volume increased drastically and reached 71 ml in the seventies. The volume of the brain was standardized for comparison between different-sized heads (brain volume index: BVI). The mean BVI decreased with statistical significance after 40 years of age. Mental function of these persons were evaluated using Hasegawa's dementia rating scale for the elderly. Progression of brain atrophy accompanied loss of mental activities (p less than 0.01).
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Abstract Regional and global cerebral atrophy are inevitable features of Alzheimer's disease (AD). We assessed volumes and atrophy rates of brain structures in patients with familial AD during the period that they developed symptoms. Five patients with presymptomatic AD and 20 controls had two or more annual volumetric MRI brain scans. Volumes of brain, ventricles, temporal lobes, hippocampi, and entorhinal cortices (ECs) were measured. Rates of volume change were calculated from serial scans. There were no significant differences in baseline measures of whole brain, temporal lobe, or ventricular volume between patients and controls; averaged volumes of medial temporal lobe structures (both hippocampi and ECs) were 16.6% (95% confidence interval [CI], 3.3–28.0%) lower in patients. Atrophy rates for brain, temporal lobe, hippocampus, and EC were significantly increased in patients compared with controls ( p < 0.05). Averaged atrophy rates from both hippocampi and ECs were 5.1% (95% CI, 3.0–7.1%) greater in patients than controls. Linear extrapolation backward suggested medial temporal lobe atrophy commenced 3.5 years (95% CI, 0.7–7.5 years) before onset, when all patients were asymptomatic. We conclude that increased medial temporal lobe atrophy rates are an early and distinguishing feature of AD and that pathological atrophy probably is occurring several years before the onset of symptoms. Ann Neurol 2003;53:000–000
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