Medial temporal lobe atrophy score

The medial temporal lobe atrophy (MTA) score is useful in distinguishing patients with mild cognitive impairment and Alzheimer's disease from those without impairment 2 is helpful in the assessment of patients with possible dementia (see neurodegenerative MRI brain - an approach). 

Classification

It is a visual score performed on MRI of the brain using coronal T1 weighted images through the hippocampus at the level of the anterior pons and assesses three features 1,3:

  1. width of the choroid fissure
  2. width of the temporal horn of the lateral ventricle
  3. height of the hippocampus

These result in a score of 0 to 4:

  • 0: no CSF is visible around the hippocampus
  • 1: choroid fissure is slightly widened
  • 2: moderate widening of the choroid fissure, mild enlargement of the temporal horn and mild loss of hippocampal height 
  • 3: marked widening of the choroid fissure, moderate enlargement of the temporal horn, and moderate loss of hippocampal height 
  • 4: marked widening of the choroid fissure, marked enlargement of the temporal horn, and the hippocampus is markedly atrophied and internal structure is lost

The score is interpreted in relation to age:

  • < 75 years: ≥ 2 is abnormal
  • ≥ 75 years: ≥ 3 is abnormal

Atrophy has been shown to correlate with likelihood of progression from mild cognitive impairment (MCI) to dementia 4

Neurodegenerative diseases

Neurodegenerative diseases are legion and their classification just as protean. A useful approach is to divide them according to underlying pathological process, although even using this schema, there is much overlap and thus resulting confusion.

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rID: 28451
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