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Medial temporal lobe width on CT scanning in Alzheimer's disease: Comparison with vascular dementia, depression and dementia with Lewy bodies

Lookup NU author(s): Professor John O'Brien, Dr Alan Swann, Dr Clive Ballard, Professor Ian McKeith, Dr Anil Gholkar OBE

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Abstract

A simple linear measurement of the minimum width of the medial temporal lobe (MTL) on angled CT scans has been suggested as an accurate ante-mortem marker for Alzheimer's disease (AD). To determine the clinical utility and specificity of this finding, we performed angled CT scans with 5-mm slices in 116 subjects referred to a geographically based Old Age Psychiatry service in Newcastle. Diagnoses were of NINCDS/ADRDA AD (n = 69, 36 probable and 33 possible). NINDS/AIREN vascular dementia (VaD, n = 25), consensus criteria for dementia with Lewy bodies (DLB, n = 9) and DSM-IV criteria for major depression (n = 13). Subjects were well matched for age. Minimum MTL width was significantly greater in depressed subjects (13.7 mm) compared to those with dementia, though no differences were seen within the dementia groups (AD 10.8, VaD 10.4, and DLB 10.9 mm). An MTL width below 11.5 mm had a sensitivity of 54% (56/103) and a specificity of 77% (10/13) for distinguishing dementia from depression. We conclude that a single cross-sectional measurement of MTL width on CT does not help differentiate between different types of dementia, though it may provide some supportive evidence when distinguishing depression from dementia. Copyright (C) 2000 S. Karger AG, Basel.


Publication metadata

Author(s): Gholkar A; McKeith I; O'Brien JT; Ballard C; Swann A; Metcalfe S; Hobson J; Jobst K

Publication type: Article

Publication status: Published

Journal: Dementia and Geriatric Cognitive Disorders

Year: 2000

Volume: 11

Issue: 2

Pages: 114-118

Print publication date: 01/03/2000

ISSN (print): 1420-8008

ISSN (electronic): 1421-9824

Publisher: S Karger AG

URL: http://dx.doi.org/10.1159/000017223

DOI: 10.1159/000017223

PubMed id: 10705169


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