Generic placeholder image

Current Alzheimer Research


ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

Research Article

The Parietal Atrophy Score on Brain Magnetic Resonance Imaging is a Reliable Visual Scale

Author(s): David Silhan, Ales Bartos*, Jana Mrzilkova, Olga Pashkovska, Ibrahim Ibrahim and Jaroslav Tintera

Volume 17, Issue 6, 2020

Page: [534 - 539] Pages: 6

DOI: 10.2174/1567205017666200807193957

open access plus


Aims: The purpose of the study was to evaluate the reliability of our new visual scale for a quick atrophy assessment of parietal lobes on brain Magnetic Resonance Imaging (MRI) among different professionals. A good agreement would justify its use for differential diagnosis of neurodegenerative dementias, especially early-onset Alzheimer’s Disease (AD), in clinical settings.

Methods: The visual scale named the Parietal Atrophy Score (PAS) is based on a semi-quantitative assessment ranging from 0 (no atrophy) to 2 (prominent atrophy) in three parietal structures (sulcus cingularis posterior, precuneus, parietal gyri) on T1-weighted MRI coronal slices through the whole parietal lobes. We used kappa statistics to evaluate intra-rater and inter-rater agreement among four raters who independently scored parietal atrophy using PAS. Rater 1 was a neuroanatomist (JM), rater 2 was an expert in MRI acquisition and analysis (II), rater 3 was a medical student (OP) and rater 4 was a neurologist (DS) who evaluated parietal atrophy twice in a 3-month interval to assess intra-rater agreement. All raters evaluated the same 50 parietal lobes on brain MRI of 25 cognitively normal individuals with even distribution across all atrophy degrees from none to prominent according to the neurologist’s rating.

Results: Intra-rater agreement was almost perfect with the kappa value of 0.90. Inter-rater agreement was moderate to substantial with kappa values ranging from 0.43-0.86.

Conclusion: The Parietal Atrophy Score is the reliable visual scale among raters of different professions for a quick evaluation of parietal lobes on brain MRI within 1-2 minutes. We believe it could be used as an adjunct measure in differential diagnosis of dementias, especially early-onset AD.

Keywords: Parietal Atrophy Score, reliability, visual scale, brain magnetic resonance imaging, Alzheimer's disease, dementia.

LoBue C, Denney D, Hynan LS, et al. Self-reported traumatic brain injury and mild cognitive impairment: Increased risk and earlier age of diagnosis. J Alzheimers Dis 2016; 51(3): 727-36.
[] [PMID: 26890760]
LoBue C, Wadsworth H, Wilmoth K, et al. Traumatic brain injury history is associated with earlier age of onset of Alzheimer disease. Clin Neuropsychol 2017; 31(1): 85-98.
[] [PMID: 27855547]
LoBue C, Wilmoth K, Cullum CM, et al. Traumatic brain injury history is associated with earlier age of onset of frontotemporal dementia. J Neurol Neurosurg Psychiatry 2016; 87(8): 817-20.
[] [PMID: 26359171]
Lye TC, Shores EA. Traumatic brain injury as a risk factor for Alzheimer’s disease: A review. Neuropsychol Rev 2000; 10(2): 115-29.
[] [PMID: 10937919]
Roberts GW, Gentleman SM, Lynch A, Graham DI. Beta A4 amyloid protein deposition in brain after head trauma. Lancet 1991; 338(8780): 1422-3.
[] [PMID: 1683421]
Sivanandam TM, Thakur MK. Traumatic brain injury: A risk factor for Alzheimer’s disease. Neurosci Biobehav Rev 2012; 36(5): 1376-81.
[] [PMID: 22390915]
Chen XH, Siman R, Iwata A, Meaney DF, Trojanowski JQ, Smith DH. Long-term accumulation of amyloid-beta, beta-secretase, presenilin-1, and caspase-3 in damaged axons following brain trauma. Am J Pathol 2004; 165(2): 357-71.
[] [PMID: 15277212]
Hussain I, Powell D, Howlett DR, et al. Identification of a novel aspartic protease (Asp 2) as beta-secretase. Mol Cell Neurosci 1999; 14(6): 419-27.
[] [PMID: 10656250]
Johnson VE, Stewart W, Smith DH. Axonal pathology in traumatic brain injury. Exp Neurol 2013; 246: 35-43.
[] [PMID: 22285252]
Johnson VE, Stewart W, Smith DH. Traumatic brain injury and amyloid-β pathology: A link to Alzheimer’s disease? Nat Rev Neurosci 2010; 11(5): 361-70.
[] [PMID: 20216546]
Uryu K, Chen XH, Martinez D, et al. Multiple proteins implicated in neurodegenerative diseases accumulate in axons after brain trauma in humans. Exp Neurol 2007; 208(2): 185-92.
[] [PMID: 17826768]
Smith DH, Chen XH, Iwata A, Graham DI. Amyloid beta accumulation in axons after traumatic brain injury in humans. J Neurosurg 2003; 98(5): 1072-7.
[] [PMID: 12744368]
Smith DH, Uryu K, Saatman KE, Trojanowski JQ, McIntosh TK. Protein accumulation in traumatic brain injury. Neuromolecular Med 2003; 4(1-2): 59-72.
[] [PMID: 14528053]
Smith DH, Chen XH, Nonaka M, et al. Accumulation of amyloid beta and tau and the formation of neurofilament inclusions following diffuse brain injury in the pig. J Neuropathol Exp Neurol 1999; 58(9): 982-92.
[] [PMID: 10499440]
Yuan Q, Su H, Zhang Y, et al. Amyloid pathology in spinal cord of the transgenic Alzheimer’s disease mice is correlated to the corticospinal tract pathway. J Alzheimers Dis 2013; 35(4): 675-85.
[] [PMID: 23478304]
Janus C, Westaway D. Transgenic mouse models of Alzheimer’s disease. Physiol Behav 2001; 73(5): 873-86.
[] [PMID: 11566220]
Yuan Q, Su H, Zhang Y, et al. Existence of different types of senile plaques between brain and spinal cord of TgCRND8 mice. Neurochem Int 2013; 62(3): 211-20.
[] [PMID: 23333593]
Aho L, Pikkarainen M, Hiltunen M, Leinonen V, Alafuzoff I. Immunohistochemical visualization of amyloid-beta protein precursor and amyloid-beta in extra- and intracellular compartments in the human brain. J Alzheimers Dis 2010; 20(4): 1015-28.
[] [PMID: 20413866]
Joshi G, Gan KA, Johnson DA, Johnson JA. Increased Alzheimer’s disease-like pathology in the APP/PS1ΔE9 mouse model lacking Nrf2 through modulation of autophagy. Neurobiol Aging 2015; 36(2): 664-79.
[] [PMID: 25316599]
Fleminger S, Oliver DL, Lovestone S, Rabe-Hesketh S, Giora A. Head injury as a risk factor for Alzheimer’s disease: The evidence 10 years on; a partial replication. J Neurol Neurosurg Psychiatry 2003; 74(7): 857-62.
[] [PMID: 12810767]
Magnoni S, Brody DL. New perspectives on amyloid-beta dynamics after acute brain injury: moving between experimental approaches and studies in the human brain. Arch Neurol 2010; 67(9): 1068-73.
[] [PMID: 20837849]
Ikonomovic MD, Uryu K, Abrahamson EE, et al. Alzheimer’s pathology in human temporal cortex surgically excised after severe brain injury. Exp Neurol 2004; 190(1): 192-203.
[] [PMID: 15473992]
Marklund N, Blennow K, Zetterberg H, Ronne-Engström E, Enblad P, Hillered L. Monitoring of brain interstitial total tau and beta amyloid proteins by microdialysis in patients with traumatic brain injury. J Neurosurg 2009; 110(6): 1227-37.
[] [PMID: 19216653]
Bird SM, Sohrabi HR, Sutton TA, et al. Cerebral amyloid-β accumulation and deposition following traumatic brain injury--A narrative review and meta-analysis of animal studies. Neurosci Biobehav Rev 2016; 64: 215-28.
[] [PMID: 26899257]
Hannila SS, Siddiq MM, Filbin MT. Therapeutic approaches to promoting axonal regeneration in the adult mammalian spinal cord. Int Rev Neurobiol 2007; 77: 57-105.
[] [PMID: 17178472]
Ward RE, Huang W, Kostusiak M, Pallier PN, Michael-Titus AT, Priestley JV. A characterization of white matter pathology following spinal cord compression injury in the rat. Neuroscience 2014; 260: 227-39.
[] [PMID: 24361176]
Gentleman SM, Nash MJ, Sweeting CJ, Graham DI, Roberts GW. Beta-amyloid precursor protein (beta APP) as a marker for axonal injury after head injury. Neurosci Lett 1993; 160(2): 139-44.
[] [PMID: 8247344]
Ropper AE, Zeng X, Anderson JE, et al. An efficient device to experimentally model compression injury of mammalian spinal cord. Exp Neurol 2015; 271: 515-23.
[] [PMID: 26210871]
Nakagawa Y, Nakamura M, McIntosh TK, et al. Traumatic brain injury in young, amyloid-beta peptide overexpressing transgenic mice induces marked ipsilateral hippocampal atrophy and diminished Abeta deposition during aging. J Comp Neurol 1999; 411(3): 390-8.
[<390: AID-CNE3>3.0.CO;2-#] [PMID: 10413774]
Nakagawa Y, Reed L, Nakamura M, et al. Brain trauma in aged transgenic mice induces regression of established abeta deposits. Exp Neurol 2000; 163(1): 244-52.
[] [PMID: 10785464]
Rezai-Zadeh K, Gate D, Gowing G, Town T. How to get from here to there: Macrophage recruitment in Alzheimer’s disease. Curr Alzheimer Res 2011; 8(2): 156-63.
[] [PMID: 21345166]
Cameron B, Landreth GE. Inflammation, microglia, and Alzheimer’s disease. Neurobiol Dis 2010; 37(3): 503-9.
[] [PMID: 19833208]

© 2022 Bentham Science Publishers | Privacy Policy