Neuro MRI shows cost-effective cognitive tests best for monitoring Alzheimer’s

Older patients with mild cognitive impairment (MCI) marked mainly by memory loss are most accurately evaluated with intensive neuropsychological test batteries. However, if such mental decline progresses to full-on Alzheimer’s disease, the patients are better monitored with the quicker, less costly Mini-Mental State Examination (MMSE).

That’s according to MRI-backed research conducted in South Korea. The journal Dementia and Geriatric Cognitive Disorders published the findings online Aug. 3.

A team led by Jae-Jin Kim, MD, PhD, of Yonsei University College of Medicine in Seoul reviewed the cases of 114 patients with amnestic MCI and 90 patients with Alzheimer’s.

All patients had undergone various assessments of cognitive function and been imaged with 3D, T1-weighted MRI at least twice.

The researchers looked for correlations between annually declining functional test scores and changes in cortical gray matter volume on the MRI.

They found that that, in the MCI patients, changes in the total score of one test, a dementia-specific version of the Seoul Neuropsychological Screening Battery, showed a strong correlation with loss of gray matter.

This correlation was also present, albeit to a lesser degree, with the Clinical Dementia Rating Scale Sum of Boxes.

The team found no such correlation with the MMSE.

In the Alzheimer’s patients, decline in all three test scores correlated significantly with gray-matter loss, and MMSE had the strongest correlation (r = 0.464, p < 0.001).

“In amnestic MCI patients, neuropsychological battery, though time-consuming, was the most adequate tool in tracking disease progression,” the authors write. “In Alzheimer’s disease patients, however, MMSE may be the most effective longitudinal monitoring tool when considering cost-effectiveness.”