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Clinical use of structural magnetic resonance imaging in the diagnosis of dementia in adults with Down's syndrome

Published online by Cambridge University Press:  13 June 2014

Andre Strydom ,
Angela Hassiotis  and
Zuzana Walker
Zuzana Walker
Affiliation:
Department of Psychiatry and Behavioural Sciences, University College London, 48 Riding House Street, London, WIN 8AA, England
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Abstract

Objectives: Magnetic Resonance Imaging (MRI) has been used to assist the diagnosis of Alzheimer's Disease (AD) in adults with Down's syndrome (DS). However, the interpretation of the scans is difficult and clinical usefulness is uncertain. We aimed to summarise the current knowledge of MRI studies in adults with Down's syndrome with and without dementia and to discuss its implications for clinical practice.

Method: We identified MRI studies in DS by a computerised literature search with Medline, Embase, and Psychlit from 1986 to 2001. We examined the references of identified articles and hand searched relevant journals. Structural MRI studies were selected as this type of imaging is most frequently used in clinical practice.

Results: We included eight volumetric studies in adults with DS. Four of these included adults with DS and dementia. Overall, the size of brain structures such as cerebellum, hippocampus and cortex of adults with DS without dementia was significantly smaller than in normal controls. The basal ganglia were similar in size, and ventricles were enlarged. Furthermore, the size of brain structures in adults with DS and dementia was significantly different than in DS without dementia. In particular, ventricular and hippocampal volumes were affected.

Conclusions: The change in brain structure associated with dementia can be detected on MRI of adults with DS. However, these may be difficult to interpret given the extent to which brain appearance in DS differs from that in the general population. Implications for clinical practice and future research directions are discussed.

Keywords

MRIVolumetricStructuralDiagnosisDementiaDown's syndromeClinical practice
Type
Brief Reports
Information
Irish Journal of Psychological Medicine , Volume 19 , Issue 2 , June 2002 , pp. 60 - 63
Copyright
Copyright © Cambridge University Press 2002

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References

1.Emerson, JF, Kesslak, JP, Chen, PCet al.Magnetic resonance imaging of the aging brain in Down syndrome. Prog Clin Biol Res 1995; 393: 123–38.Google ScholarPubMed
2.Prasher, VP, Barber, PC, West, Ret al.The role of magnetic resonance imaging in the diagnosis of Alzheimer disease in adults with Down syndrome. Arch Neurol 1996; 53: 1310–3.CrossRefGoogle ScholarPubMed
3.Weis, S, Weber, G, Neuhold, Aet al.Down syndrome: MR quantification of brain structures and comparison with normal subjects. Am J Neuroradiol 1991; 12: 1207–11.Google Scholar
4.Pearlson, GD, Breiter, SN, Aylward, EHet al.MRI brain changes in subjects with Down syndrome with and without dementia. Dev Med Child Neurol 1998; 40: 326–34.Google ScholarPubMed
5.Frangou, S, Aylward, E, Warren, Aet al.Small planum temporale volume in Down's syndrome: a volumetric MRI study. Am J Psychiatry 1997; 154: 1424–9.Google ScholarPubMed
6.Aylward, EH, Habbak, R, Warren, Aet al.Cerebellar volume in adults with Down syndrome. Arch Neurol 1997; 54: 209–12.CrossRefGoogle ScholarPubMed
7.Aylward, EH, Li, Q, Habbak, Ret al.Basal ganglia volume in adults with Down syndrome. Psychiatry Res 1997; 74: 73–82.CrossRefGoogle ScholarPubMed
8.Aylward, EH, Li, Q, Honeycutt, NAet al.MRI volumes of the hippocampus and amygdala in adults with Down's syndrome with and without dementia. Am J Psychiatry 1999; 156: 564–8.CrossRefGoogle ScholarPubMed
9.Raz, N, Torres, IJ, Briggs, SDet al.Selective neuroanatomic abnormalities in Down's syndrome and their cognitive correlates: evidence from MRI morphometry. Neurology 1995; 45: 356–66.CrossRefGoogle ScholarPubMed
10.Pinter, JD, Eliez, S, Scmitt, JE, Capone, GT, Reiss, AL. Neuroanatomy of Down's Syndrome: a high-resolution MRI Study. Am J Psychiatry 2001; 158, 1659–65.CrossRefGoogle ScholarPubMed
11.Haier, RJ, Chueh, D, Touchette, Pet al.Brain size and cerebral glucose metabolic rate in nonspecific mental retardation and Down syndrome. Intelligence 1995; 20: 191–210.CrossRefGoogle Scholar
12.Jernigan, TL, Bellugi, U, Sowell, Eet al.Cerebral morphologic distinctions between Williams and Down syndromes. Arch Neurol 1993; 50: 186–19.CrossRefGoogle ScholarPubMed
13.Weis, S. Morphometry and magnetic resonance imaging of the human brain in normal controls and Down's syndrome. Anat Rec 1991; 231: 593–8.CrossRefGoogle ScholarPubMed
14.Kesslak, JP, Nagata, SF, Lott, Iet al.Magnetic resonance imaging analysis of age-related changes in the brains of individuals with Down's syndrome. Neurology 1994; 44: 1039–45.CrossRefGoogle ScholarPubMed
15.Roth, GM, Sun, B, Greensite, FSet al.Premature aging in persons with Down syndrome: MR findings. Am J Neuroradiol 1996; 17, 1283–9.Google ScholarPubMed
16.Pelz, DM, Karlik, SJ, Fox, AJ, Vinuela, F. Magnetic resonance imaging in Down's syndrome. Can J Neurological Sci 1986; 13,(4): 566–9.CrossRefGoogle ScholarPubMed
17.Tamraz, JC, Rethoré, MO, Iba-Zizen, MT, Lejeune, J, Cabanis, EA. Contribution of magnetic resonance imaging to the knowledge of CNS malformations related to chromosomal aberrations. Hum Genet 1987; 76: 265–73.CrossRefGoogle Scholar
18.Gangadharan, S, Bhaumik, S. Clinical role of neuro-imaging in learning disability (Abstract). Royal College of Psychiatrists Faculty of the Psychiatry of Learning Disability, 2000 Annual Residential Meeting.Google Scholar
19.McKhann, G, Drachmann, D, Folstein, Met al.Clinical diagnosis of Alzheimer's disease: report of the NINCDS/ADRDA Work Group under the auspices of Health and Human Services Task Force on Alzheimer's disease. Neurology 1984; 34, 939–44.CrossRefGoogle ScholarPubMed
20.Scheltens, P, Leys, D, Barkhof, Fet al.Atrophy of medial temporal lobes on MRI in ‘probable’ Alzheimer's disease and normal ageing: diagnostic value and neuropsychological correlates. J Neurol Neurosurg Psychiatry 1992; 55: 967–72.CrossRefGoogle ScholarPubMed
21.Birks, JS, Melzer, D. Donepezil for mild and moderate Alzheimer's disease (Cochrane Review). Cochrane Database Syst Rev 2000; 3. Oxford: Update Software.Google Scholar
22.Birks, J, Grimley Evans, J, Iakovidou, Vet al.Rivastigmine for Alzheimer's disease (Cochrane Review). Cochrane Database Syst Rev 2000; 4, Oxford: Update Software.Google Scholar
23.Tariot, PN, Solomon, PR, Morris, JCet al.A five month, randomized, placebo-controlled trial of galantamine in AD. The Galantamine USA-10 Study Group. Neurology 2000; 54, 2269–2276.CrossRefGoogle Scholar
24.Fox, NC, Warrington, EK, Freeborough, PAet al.Presymptomatic hippocampal atrophy in Alzheimer's disease. A longitudinal MRI study. Brain 1996; 119: 2001–7.CrossRefGoogle ScholarPubMed
25.Jack, CR, Petersen, RC, Xu, Yet al.Rates of hippocampal atrophy correlate with change in clinical status in aging and AD. Neurology 2000; 55: 484–9.CrossRefGoogle ScholarPubMed
26.Lawlor, BA, McCarron, M, Wilson, G, McLoughlin, M. Temporal lobe-oriented scanning and dementia in Down's syndrome. Int J Geriatric Psychiat 2001; 16: 427–29.CrossRefGoogle ScholarPubMed
27.Wright, IC, Rabe-Hesketh, S, Woodruff, PWRet al.Meta-analysis of regional brain volumes in schizophrenia. Am J Psychiatry 2000; 157: 16–25.CrossRefGoogle ScholarPubMed