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Potential Role of Diffusion Tensor MRI in the Differential Diagnosis of Mild Cognitive Impairment and Alzheimer's Disease

¹ Clinica de Diagnóstico Por Imagem, Ave. das Américas 4666, sala 32522649-900, Rio de Janeiro, Brazil.
² Multi-Imagem, Rio de Janeiro, Brazil.
³ Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

OBJECTIVE. The purpose of this study was to evaluate the fractional anisotropy values of several white matter tracts with the aim of differentiating a healthy population from persons with mild cognitive impairment or Alzheimer's disease.

SUBJECTS AND METHODS. Seventy-nine patients with memory impairment and 16 volunteer controls participated in the study. MRI was performed with a 1.5-T system. Conventional MR images and diffusion tensor images were obtained for all participants. The diffusion tensor imaging data were postprocessed, and low b-value, fractional anisotropy, and fractional anisotropy color-coded maps were calculated. With the three maps as an anatomic reference, fractional anisotropy was measured for hippocampal formations, superior longitudinal fascicles, posterior cingulate gyri, and the splenium of the corpus callosum. Kruskal-Wallis and Steel-type multiple-comparison nonparametric tests were performed for the statistical analysis.

RESULTS. The fractional anisotropy values for the splenium of the corpus callosum, bilateral posterior cingulate gyri, and bilateral superior longitudinal fascicles of patients with mild cognitive impairment and those with probable Alzheimer's disease were significantly lower than the values of controls. No differences were found in hippocampal formations in any group. No significant difference was found in fractional anisotropy values in comparisons of mild cognitive impairment versus possible Alzheimer's disease and probable Alzheimer's disease or comparisons of probable Alzheimer's disease and possible Alzheimer's disease.

CONCLUSION. Diffusion tensor imaging is a promising technique for the evaluation of patients with probable mild cognitive impairment. Early detection of the disease expands the treatment options, increasing the likelihood of a good clinical response and enhancing the quality of life of patients and their relatives. Further studies with larger populations are needed to confirm the role of diffusion tensor imaging in the evaluation of memory impairment.

Keywords: Alzheimer's disease • corpus callosum • diffusion tensor imaging • fractional anisotropy • mild cognitive impairment • MRI • posterior cingulate gyrus • splenium • superior longitudinal fascicles

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