Asunto(s)
Dolor Facial/diagnóstico , Bandas Oligoclonales/líquido cefalorraquídeo , Oftalmoplejía/diagnóstico , Órbita/fisiopatología , Síndrome de Tolosa-Hunt/diagnóstico , Adulto , Dolor Facial/líquido cefalorraquídeo , Dolor Facial/tratamiento farmacológico , Dolor Facial/fisiopatología , Femenino , Glucocorticoides/farmacología , Humanos , Imagen por Resonancia Magnética , Oftalmoplejía/líquido cefalorraquídeo , Oftalmoplejía/tratamiento farmacológico , Oftalmoplejía/fisiopatología , Síndrome de Tolosa-Hunt/líquido cefalorraquídeo , Síndrome de Tolosa-Hunt/tratamiento farmacológico , Síndrome de Tolosa-Hunt/fisiopatología , Adulto JovenAsunto(s)
Enfermedad Celíaca/complicaciones , Encefalomielitis Aguda Diseminada/complicaciones , Antígenos CD/metabolismo , Antivirales/uso terapéutico , Enfermedad Celíaca/diagnóstico por imagen , Enfermedad Celíaca/cirugía , Encefalomielitis Aguda Diseminada/diagnóstico por imagen , Encefalomielitis Aguda Diseminada/tratamiento farmacológico , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Sustancia Blanca/diagnóstico por imagenRESUMEN
BACKGROUND: Atrophy of the medial temporal lobe (MTL) is a biological characteristic of Alzheimer's disease (AD) and can be measured by segmentation of magnetic resonance images (MRI). OBJECTIVE: To assess the clinical utility of automated volumetry in a cognitively well-defined and biomarker-classified multi-center longitudinal predementia cohort. METHODS: We used Automatic Segmentation of Hippocampal Subfields (ASHS) to determine MTL morphometry from MRI. We harmonized scanner effects using the recently developed longitudinal ComBat. Subjects were classified according to the A/T/N system, and as normal controls (NC), subjective cognitive decline (SCD), or mild cognitive impairment (MCI). Positive or negative values of A, T, and N were determined by cerebrospinal fluid measurements of the Aß42/40 ratio, phosphorylated and total tau. From 406 included subjects, longitudinal data was available for 206 subjects by stage, and 212 subjects by A/T/N. RESULTS: Compared to A-/T-/N- at baseline, the entorhinal cortex, anterior and posterior hippocampus were smaller in A+/T+orN+. Compared to NC A- at baseline, these subregions were also smaller in MCI A+. Longitudinally, SCD A+ and MCI A+, and A+/T-/N- and A+/T+orN+, had significantly greater atrophy compared to controls in both anterior and posterior hippocampus. In the entorhinal and parahippocampal cortices, longitudinal atrophy was observed only in MCI A+ compared to NC A-, and in A+/T-/N- and A+/T+orN+ compared to A-/T-/N-. CONCLUSION: We found MTL neurodegeneration largely consistent with existing models, suggesting that harmonized MRI volumetry may be used under conditions that are common in clinical multi-center cohorts.