Volumetric MRI vs clinical predictors of Alzheimer disease in mild cognitive impairment
Fleisher AS, Sun S, Taylor C, Ward CP, Gamst AC, Petersen RC, Jack CR, Aisen PS et al.. Neurology, 2008-01-01
Topic: Amyloid, tau and blood-test diagnosis
Objective To compare volumetric MRI of whole brain and medial temporal lobe structures to clinical measures for predicting progression from amnestic mild cognitive impairment (MCI) to Alzheimer disease (AD). Methods Baseline MRI scans from 129 subjects with amnestic MCI were obtained from participants in the Alzheimer's Disease Cooperative Study group's randomized, placebo-controlled clinical drug trial of donepezil, vitamin E, or placebo. Measures of whole brain, ventricular, hippocampal, and entorhinal cortex volumes were acquired. Participants were followed with clinical and cognitive evaluations until formal criteria for AD were met, or completion of 36 months of follow-up. Logistic regression modeling was done to assess the predictive value of all MRI measures, risk factors such as APOE genotype, age, family history of AD, education, sex, and cognitive test scores for progression to AD. Least angle regression modeling was used to determine which variables would produce an optimal predictive model, and whether adding MRI measures to a model with only clinical measures would improve predictive accuracy. Results Of the four MRI measures evaluated, only ventricular volumes and hippocampal volumes were predictive of progression to AD. Maximal predictive accuracy using only MRI measures was obtained by hippocampal volumes by themselves (60.4%). When clinical variables were added to the model, the predictive accuracy increased to 78.8%. Use of MRI measures did not improve predictive accuracy beyond that obtained by cognitive measures alone. APOE status, MRI, or demographic variables were not necessary for the optimal predictive model. This optimal model included the Delayed 10-word list recall, New York University Delayed Paragraph Recall, and the Alzheimer's Disease Assessment Scale-Cognitive Subscale total score. Conclusion In moderate stages of amnestic mild cognitive impairment, common cognitive tests provide better predictive accuracy than measures of whole brain, ventricular, entorhinal cortex, or hippocampal volumes for assessing progression to Alzheimer disease.
Key findings
- Results Of the four MRI measures evaluated, only ventricular volumes and hippocampal volumes were predictive of progression to AD.
Why it matters
In 129 people with amnestic mild cognitive impairment, only ventricular and hippocampal volumes predicted progression to Alzheimer's disease, with hippocampal volumes alone giving maximal predictive accuracy of 60.4% among MRI measures. This concerns prediction of progression and does not test any treatment, cure, or prevention.
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Study details
- Participants129
- Effect size60.4%; 78.8%
- Evidence strengthHigh
How this study scored 73/100
Published in a leading specialty journal, and it is a randomised controlled trial.
| 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 | 11 / 12 | A randomised controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2008 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 129 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 2 / 2 | Randomised and blinded or placebo-controlled (as stated in the record) |
| Times cited | 5 / 7 | Cited 181 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 9.1 citations a year over 20 year(s) since 2008 |
| Impact for its field and year | 4 / 6 | Cited 14.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 17 other studies in this library |
| Still being cited | 1 / 4 | Cited 10 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Leon J. Thal: h-index 64 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California San Diego: institution h-index 1,852 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 18195264) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 73 / 100 | — |
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APA 7th
Fleisher, A. S., Sun, S., Taylor, C., Ward, C. P., Gamst, A. C., Petersen, R. C., et al. (2008). Volumetric MRI vs clinical predictors of Alzheimer disease in mild cognitive impairment. Neurology. https://doi.org/10.1212/01.wnl.0000287091.57376.65
Vancouver
Fleisher AS, Sun S, Taylor C, Ward CP, Gamst AC, Petersen RC, et al. Volumetric MRI vs clinical predictors of Alzheimer disease in mild cognitive impairment. Neurology. 2008. doi:10.1212/01.wnl.0000287091.57376.65. PMID: 18195264.
BibTeX
@article{fleisher2008-18195264,
author = {Fleisher, A. S. and Sun, S. and Taylor, C. and Ward, C. P. and Gamst, A. C. and Petersen, R. C. and Jack, C. R. and Aisen, P. S. and others},
title = {{Volumetric MRI vs clinical predictors of Alzheimer disease in mild cognitive impairment}},
journal = {Neurology},
year = {2008},
doi = {10.1212/01.wnl.0000287091.57376.65},
pmid = {18195264},
url = {https://doi.org/10.1212/01.wnl.0000287091.57376.65}
}
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