MRI visual rating of cognitive impairment in elderly patient

Abstract

Background: Neurocognitive impairment is an acquired deficiency of cognitive abilities that significantly interferes with performance of daily activities. Early diagnosis is key in the management which is dependent on employing appropriate biomarkers. Cerebral atrophy is a valid neuroimaging biomarker. This study aims to correlate cerebral atrophy using standard visual assessment scales on Magnetic Resonance Imaging (MRI) with cognitive status using a standard cognition assessment tool in elderly patients at the University College Hospital, Ibadan Nigeria.

Methods: Patients over 60 years who presented for cranial MRI and met the inclusion criteria were recruited into the study which spanned a 10-month period. Relevant demographic and clinical information were obtained from the participants. Visual rating scores comprising Medial Temporal Atrophy (MTA), Fazekas, Koedam and Global Cortical Atrophy (GCA) of the images were entered into a standard proforma and the Statistical Package for the Social Sciences (SPSS) software version 20. Data was analyzed using chi square, student t-test, Spearman Rho test, Kruskal-Wallis test, Mann-Whitney Wilcoxon test, and logistic regression analysis.

Results: Spearman Rho test showed significant association between MTA and Fazekas scores and between Koedam and GCA scores. Significant association between MTA scores and severity of cognitive impairment by Mann-Whitney Wilcoxon test was shown. Kruskal-Wallis showed significant association between Fazekas scores and severity of cognitive impairment.

Conclusion: Medial temporal lobe atrophy is a useful marker of cognitive impairment and severity of cognitive impairment. White matter disease is significantly associated with the presence of and severity of cognitive impairment. Both can serve as useful neuroimaging biomarkers.