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Predicting MCI outcome with clinically available MRI and CSF biomarkers
Heister D, Brewer JB, Magda S, Blennow K, McEvoy LK, Alzheimer's Disease Neuroimaging Initiative.. Neurology, 2011-10-12
Topic: Risk, prevention and care in population studies
Objective To determine the ability of clinically available volumetric MRI (vMRI) and CSF biomarkers, alone or in combination with a quantitative learning measure, to predict conversion to Alzheimer disease (AD) in patients with mild cognitive impairment (MCI). Methods We stratified 192 MCI participants into positive and negative risk groups on the basis of 1) degree of learning impairment on the Rey Auditory Verbal Learning Test; 2) medial temporal atrophy, quantified from Food and Drug Administration-approved software for automated vMRI analysis; and 3) CSF biomarker levels(.) We also stratified participants based on combinations of risk factors. We computed Cox proportional hazards models, controlling for age, to assess 3-year risk of converting to AD as a function of risk group and used Kaplan-Meier analyses to determine median survival times. Results When risk factors were examined separately, individuals testing positive showed significantly higher risk of converting to AD than individuals testing negative (hazard ratios [HR] 1.8-4.1). The joint presence of any 2 risk factors substantially increased risk, with the combination of greater learning impairment and increased atrophy associated with highest risk (HR 29.0): 85% of patients with both risk factors converted to AD within 3 years, vs 5% of those with neither. The presence of medial temporal atrophy was associated with shortest median dementia-free survival (15 months). Conclusions Incorporating quantitative assessment of learning ability along with vMRI or CSF biomarkers in the clinical workup of MCI can provide critical information on risk of imminent conversion to AD.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Heister, D., Brewer, J. B., Magda, S., Blennow, K., McEvoy, L. K., & Alzheimer's Disease Neuroimaging Initiative. (2011). Predicting MCI outcome with clinically available MRI and CSF biomarkers. Neurology. https://doi.org/10.1212/wnl.0b013e3182343314
Vancouver
Heister D, Brewer JB, Magda S, Blennow K, McEvoy LK, Alzheimer's Disease Neuroimaging Initiative. Predicting MCI outcome with clinically available MRI and CSF biomarkers. Neurology. 2011. doi:10.1212/wnl.0b013e3182343314. PMID: 21998317.
BibTeX
@article{heister2011-21998317,
author = {Heister, D. and Brewer, J. B. and Magda, S. and Blennow, K. and McEvoy, L. K. and {Alzheimer's Disease Neuroimaging Initiative}},
title = {{Predicting MCI outcome with clinically available MRI and CSF biomarkers}},
journal = {Neurology},
year = {2011},
doi = {10.1212/wnl.0b013e3182343314},
pmid = {21998317},
url = {https://doi.org/10.1212/wnl.0b013e3182343314}
}
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Key findings
- Results When risk factors were examined separately, individuals testing positive showed significantly higher risk of converting to AD than individuals testing negative (hazard ratios [HR] 1.8-4.1).
- The joint presence of any 2 risk factors substantially increased risk, with the combination of greater learning impairment and increased atrophy associated with highest risk (HR 29.0): 85% of patients with both risk factors converted to AD within 3 years, vs 5% of those with neither.
- The presence of medial temporal atrophy was associated with shortest median dementia-free survival (15 months).
Why it matters
In people with mild cognitive impairment, combining a learning test with MRI-measured medial temporal atrophy identified those at much higher risk of converting to Alzheimer disease within three years. This is about predicting who will develop the disease, not about treating, curing, or preventing it.
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Study details
- Effect sizeHR 29.0
- Evidence strengthLow
How this study scored 52/100
Published in a leading specialty journal. Scored zero for study design, sample size, studied in people and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 50 of the 96 points we could judge it on, which is 52 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2011 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 203 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 11.9 citations a year over 17 year(s) since 2011 |
| Impact for its field and year | 4 / 6 | Cited 12.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 14 other studies in this library |
| Still being cited | 2 / 4 | Cited 20 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | 2 / 3 | University of California San Diego: institution h-index 1,852 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 21998317) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 50 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 50 of the 96 points we could judge it on is 52 out of 100. |
| Total | 52 / 100 | — |
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