Ventricular enlargement and its clinical correlates in the imaging cohort from the ADCS MCI donepezil/vitamin E study

Abstract

We analyzed the baseline and 3-year T1-weighted magnetic resonance imaging data of 110 amnestic mild cognitive impairment (MCI) participants with minimal hippocampal atrophy at baseline from the Alzheimer's Disease Cooperative Study group MCI Donepezil/Vitamin E trial. Forty-six subjects converted to Alzheimer disease (AD) (MCIc), whereas 64 remained stable (MCInc). We used the radial distance technique to examine the differences in lateral ventricle shape and size between MCIc and MCInc and the associations between ventricular enlargement and cognitive decline. MCIc group had significantly larger frontal and right body/occipital horns relative to MCInc at baseline and significantly larger bilateral frontal, body/occipital, and left temporal horns at follow-up. Global cognitive decline measured with AD Assessment scale cognitive subscale and Mini-Mental State Examination and decline in activities of daily living (ADL) were associated with posterior lateral ventricle enlargement. Decline in AD Assessment scale cognitive subscale and ADL were associated with left temporal and decline in Mini-Mental State Examination with right temporal horn enlargement. After correction for baseline hippocampal volume, decline in ADL showed a significant association with right frontal horn enlargement. Executive decline was associated with right frontal and left temporal horn enlargement.

Figure 1

Statistical (top) and percent difference (bottom) maps from the MCIc vs. MCInc baseline and follow-up comparisons. Regions in red or white in the statistical maps denote p<0.05.

Figure 2

Statistical (top) and percent difference (bottom) maps from our within-group longitudinal analyses. Regions in red or white in the statistical maps denote p<0.05.

Figure 3

Average ventricular enlargement maps in MCIc (top left) and MCInc (top right) over the course of the study (in %). The bottom maps show the statistical comparison of the magnitude of ventricular enlargement in each group over the course of the study. Regions in red or white in the statistical maps denote p<0.05.

Figure 4

Statistical maps of the associations between global cognitive and functional decline and ventricular enlargement. Regions in red or white in the statistical maps denote p<0.05)