Medial temporal lobe atrophy in memory disorders |
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Authors: | F Pasquier Michèle Hamon Florence Lebert Bruno Jacob Jean-Pierre Pruvo Henri Petit |
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Institution: | (1) Memory Disorders Unit, Department of Neurology, University Hospital, F-59037 Lille, France Fax: (33) 3 20 44 60 28, FR;(2) Department of Neuroradiology, University Hospital, F-59037 Lille, France, FR |
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Abstract: | Medial temporal lobe atrophy determined by temporal lobe oriented computed tomography (CT), 1 year before death, is strongly
associated with histopathologically confirmed Alzheimer’s disease (AD). The aim of this study was to assess the diagnostic
accuracy of medial temporal lobe measurement for the diagnosis of AD in patients referred to a memory disorders clinic, especially
those at an early stage of the disease. CT oriented to the temporal lobe was performed in 333 subjects aged 41–93 years consecutively
recruited in a Memory Disorders Clinic: 124 had probable AD, Mini Mental State score (MMS) = 17 (8); 50 possible AD MMS =
21 (5)]; and 119 patients had miscellaneous memory disorders MMS = 22 (7): frontotemporal lobe dementia, subcortical dementia,
cortical Lewy body disease, vascular dementia, Korsakoff syndrome, focal atrophy, etc.]. There were also 19 anxious/ depressed
patients MMS = 29 (1)] with normal performance on memory tests, and 21 controls. The minimum width of the medial temporal
lobe was measured. The best cut-off to distinguish AD patients from non-AD patients was 11.5 mm, in agreement with data in
the literature. At this threshold, 84% of probable AD patients had a positive test and 90% of controls and anxious/depressed
patients had a negative test. For the diagnosis of probable AD, sensitivity of the measurement was 0.81, specificity 0.95,
predictive positive value 0.99, predictive negative value 0.45, and diagnostic accuracy 0.83. The test was positive in half
the possible AD patients, and half those with miscellaneous memory disorders. It was negative in all anxious/depressed patients.
Therefore, temporal lobe oriented CT might be a valuable tool for assessment of medial temporal lobe atrophy in AD routine
practice.
Received: 27 September 1995 Accepted: 10 October 1996 |
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Keywords: | Computed tomography Hippocampal atrophy Alzheimer’ s disease Memory disorders Dementia |
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