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Review
. 2009 Nov;30(11):1711-23.
doi: 10.1016/j.neurobiolaging.2008.01.010. Epub 2008 Mar 17.

A meta-analysis of hippocampal atrophy rates in Alzheimer's disease

Josephine Barnes  1 , Jonathan W Bartlett, Laura A van de Pol, Clement T Loy, Rachael I Scahill, Chris Frost, Paul Thompson, Nick C Fox
Affiliations
Review

A meta-analysis of hippocampal atrophy rates in Alzheimer's disease

Josephine Barnes et al. Neurobiol Aging. 2009 Nov.

Abstract

Hippocampal atrophy rates are useful in both diagnosing and tracking Alzheimer's disease (AD). However, cohorts and methods used to determine such rates are heterogeneous, leading to differences in reported annualised rates. We performed a meta-analysis of hippocampal atrophy rates in AD patients and matched controls from studies reported in the peer-reviewed literature. Studies reporting longitudinal volume change in hippocampi in AD subjects together with controls were systematically identified and appraised. All authors were contacted either to confirm the results or to provide missing data. Meta-analysis and meta-regression were then performed on this data. Nine studies were included from seven centres, with data from a total of 595 AD and 212 matched controls. Mean (95% CIs) annualised hippocampal atrophy rates were found to be 4.66% (95% CI 3.92, 5.40) for AD subjects and 1.41% (0.52, 2.30) for controls. The difference between AD and control subject in this rate was 3.33% (1.73, 4.94).

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Figures

Fig. 1
Fig. 1
Forest plot of rates of atrophy in the hippocampus in AD subjects. The sizes of the squares are proportional to 1/(within-study variance +between-study variance). The solid lines represent 95% CIs.
Fig. 2
Fig. 2
Forest plot of rates of atrophy in the hippocampus in matched control subjects. The sizes of the squares are proportional to 1/(within-study variance + between-study variance estimate). The solid lines represent 95% CIs.
Fig. 3
Fig. 3
Forest plot showing the difference between AD and control subjects in studies where both were reported. The size of the squares are proportional to 1/(within-study variance + between-study variance estimate). The solid lines represent 95% CIs.
Fig. 4
Fig. 4
Funnel plot of AD rates of atrophy with pseudo 95% confidence limits.
Fig. 5
Fig. 5
Funnel plot of AD-control differences with pseudo 95% confidence limits.
Fig. 6
Fig. 6
Meta-regression of atrophy rate and mean age. The size of the circles are proportional to 1/(within-study variance + between-study variance estimate), i.e. larger circles indicate studies with more precise results.
Fig. 7
Fig. 7
Meta-regression of atrophy rate and mean MMSE score. The size of the circles are proportional to 1/(within-study variance + between-study variance), i.e. larger circles indicate studies with more precise results.
Fig. 8
Fig. 8
Meta-regression of atrophy rate and mean scan interval. The sizes of the circles are proportional to 1/(within-study variance + between-study variance), i.e. larger circles indicate studies with more precise results.
See this image and copyright information in PMC

References

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    1. Barnes J, Boyes RG, Lewis EB, Schott JM, Frost C, Scahill RI, Fox NC. Automatic calculation of hippocampal atrophy rates using a hippocampal template and the boundary shift integral. Neurobiol. Aging. 2007b;28:1657–1663. - PubMed
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