NR AXZB
AU Wroe,S.; Macfarlane,R.G.; Scahill,R.; Yousry,T.A.; Collinge,J.
TI Quantification of Brain Atrophy Rates in CJD Using Volumetric MRI
QU International Conference - Prion 2007 (26.-28.9.2007) Edinburgh International Conference Centre, Edinburgh, Scotland, UK - Book of Abstracts: Epidemiology, Risk Assessment and Transmission P04.52
IA http://www.prion2007.com/pdf/Prion Book of Abstracts.pdf
PT Konferenz-Poster
AB Brain atrophy has been described in all forms of human prion disease. Most reports are from visual inspection and subjective impression by radiologists who may or may not be blinded to diagnosis. This study applied quantitative measures of the rate of brain atrophy to patients with prion disease. Subjects were patients with any form of human prion disease. A control group of 12 age and sex matched normal subjects was also identified. MRIs were performed at 0, 1, 2, 4 and 6 months from trial enrolment and 3 monthly thereafter. All subjects and controls had T1 weighted volumetric scans acquired at 1.5T. Image processing was performed using MIDAS (Medical Image Display and Analysis Software) with a protocol for whole brain and cerebellar segmentation. Each scan was bias corrected to even out any intensity inhomogeneity and then underwent segmentation, registration and brain boundary shift integral (BSI) calculation from which annual rates of whole brain and cerebellar atrophy were calculated. All image processing was done in a blinded manner. 217 MRI scans were performed in 44 patients. Each patient had between 1 and 19 scans each (mean 4.50, median 3). Seventy nine scans were discarded, mainly due to movement artefact, leaving 138 scans remained in 31 patients. The mean interval between first and last scans in each patient was 1.24 years. One variant CJD, two sporadic CJD and 28 inherited prion disease patients (the majority with 6-OPRI or P102L PRNP mutations) were studied. Control patients were identified from a familial Alzheimer's trial and had two scans each, an average of 1.78 years apart (range1.05-3.15). This study showed that rates of brain atrophy and cerebellar atrophy were significantly higher in symptomatic CJD patients than in control patients. Mean whole brain atrophy rates were 1.3%/year higher than controls (whose mean rate was 0.17%/year). Whole brains did not atrophy at a significantly different rate to cerebelli. Atrophy rates were not significantly different according to presence of symptoms, sex, disease type or inherited disease type in this set of patients. No asymptomatic patients were deemed to have become symptomatic during the study. This is the first description of quantification of rates of brain atrophy in prion disease. Rate of brain atrophy may be a useful prognostic indicator or outcome measure in future clinical trials in human prion disease.
AD S. Wroe, R.G. Macfarlane, J. Collinge, Dept of Neurodegenerative Disease, Institute of Neurology, MRC Prion Unit, UK; R. Scahill, Institute of Neurology, UK Dementia Research group, UK; T.A. Yousry, National Hospital for Neurology and Neurosurgery, UK
SP englisch
PO Schottland
EA pdf-Datei und Poster (Posterautoren ergänzt um D. Siddique)