Regional Cerebral Blood Flow in the Posterior Cingulate and Precuneus and the Entorhinal Cortical Atrophy Score Differentiate Mild Cognitive Impairment and Dementia Due to Alzheimer Disease

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Fig 1.
ERICA scoring. A, Score 0 with no parahippocampal atrophy. B, Score 1 with mild atrophy with prominence of collateral sulcus. C, Score 2 with moderate entorhinal cortical atrophy with tentorial cleft sign (arrows). D, Score 3 with marked parahippocampal atrophy. Adapted from Enkirch et al.¹⁷
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Fig 2.
A, Axial ASL CBF gray-scale map. B and C, Sagittal and coronal representative images, respectively, of the template for automated segmentation and extraction of posterior cingulate (light gray) and precuneus (dark gray) ASL CBF perfusion maps.
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Fig 3.
Receiver operating characteristic curves for predicted probability from ERICA (dot-dash lines) and regional CBF (light gray continuous lines) and a combination of both (black continuous lines). AD versus HC (A), AD versus MCI (B), MCI versus HC (C).

Table 1:

Demographic data, comorbidities, and clinical scores of subjects

Characteristic	HC (n = 21)	MCI (n = 20)	AD (n = 19)	P Value
Characteristic	HC (n = 21)	MCI (n = 20)	AD (n = 19)	MCI versus HC	AD versus HC	AD versus MCI
Sex (male/female)	11:10	11:9	11:8	.87	.77	.88
Age (mean ± SD) (yr)	64.57 ± 5.74	66.75 ± 4.08	66.68 ± 5.31	.37	.66	1.00
H/o hypertension	5/21	7/20	9/19	.33	.11	.32
H/o diabetes mellitus	5/21	8/20	10/19	.22	.06	.32
RAVLT cumulative learning score (mean)	48.52 ± 8.46	33.47 ± 10.07	25.21 ± 7.15	<.001	<.001	.035
RAVLT 20-min recall score (mean)	10.00 ± 2.82	5.41 ± 3.74	1.36 ± 1.73	<.001	<.001	.001
ACE-M	93.38 ± 4.11	81.12 ± 11.09	72.00 ± 11.09	<.001	<.001	.020

Note:—H/o indicates History of; RAVLT, Rey auditory verbal learning test; ACE-M, Addenbrooke's Cognitive examination. Significant P values are highlighted in bold.

Table 2:

Performance of the ERICA score and CBF of PCG + PC in predicting HC, MCI, and AD

Parameters	HC (Mean)	MCI (Mean)	AD (Mean)	Predicted Probability of Diagnosis (Area under the Curve of ROC) with P Values in Parentheses
Parameters	HC (Mean)	MCI (Mean)	AD (Mean)	MCI vs HC	AD vs HC	AD vs MCI
ERICA (0–3)	0.71 ± 0.46	0.90 ± 0.64	2.15 ± 0.83	0.571 (.493)	0.887 (<.001)	0.838 (<.001)
CBF in PCG + PC (mL/100 g/min)	46.64 ± 8.4	39.08 ± 6.6	36.51 ± 8.4	0.776 (.002)	0.810 (<.001)	0.589 (.339)
Combined ERICA and CBF				0.781 (.002)	0.957 (<.001)	0.829 (<.001)