Study Validates “Gold Standard” Alzheimer’s Diagnosis Technique

A team led by UCLA researchers have validated a technique they say is the first “gold standard” for measuring atrophy in the brain’s hippocampus, an early indicator of Alzheimer’s disease.

The authors, led by Liana Apostolova, MD, director of the neuroimaging laboratory at the Mary S. Easton Center for Alzheimer’s Disease Research at UCLA, sought to validate the first evidence-based standardized methodology for measuring hippocampal atrophy—the Harmonized Hippocampal Segmentation Protocol (HarP).
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Using a 7 Tesla MRI scanner, Apostolova and her colleagues scanned the brains of 9 deceased Alzheimer’s patients and 7 cognitively normal deceased patients for approximately 60 hours. The investigators then used the HarP technique to measure patients’ hippocampal volumes, and subsequently evaluated how well this measurement correlated with 3 key Alzheimer’s indicators—the accumulation of Abeta and tau proteins in each brain as well as the loss of brain cells.

Apostolova and her team found a strong correlation between hippocampal volume and Abeta and tau protein accumulation as well as hippocampal cell loss, which the authors say offers “pathological confirmation” that hippocampal morphometry is a viable biomarker for Alzheimer’s disease, and the HarP technique is an effective method of measuring it.

“We have now validated an international standardized protocol for hippocampal segmentation that will have multiple uses in the future,” says Apostolova.

Its most immediate use will be as “the gold standard in research and clinical trials,” she says, noting that the protocol is “now ready to be implemented when testing the effects of drugs in clinical trials, or when studying disease progression.”

For decades, clinicians have relied on MRI as an ancillary diagnostic tool, continues Apostolova, adding that patients with mild cognitive impairment (MCI) or dementia are likely to have Alzheimer’s if they have small hippocampi.

“As clinicians,” she says, “we look at MRI images to assess for hippocampal atrophy on a daily basis. The newly validated internationally standardized protocol for hippocampal segmentation will help us develop software programs that can—at the click of a button—tell the physician whether hippocampal atrophy is present and how severe it is.”

The ability to take such a quantitative approach, says Apostolova, “will revolutionize our clinical care, as it will provide an accurate and unbiased assessment.”

—Mark McGraw

Reference

Apostolova L, Zarow C, et al. Relationship between hippocampal atrophy and neuropathy markers: A 7T MRI validation study of the EADC-ADN Harmonized Hippocampal Segmentation Protocol. Alzheimer's and Dementia. 2015.