Posterior atrophy and medial temporal atrophy scores are associated with different symptoms in patients with Alzheimer's disease and mild cognitive impairment

Background Whether the occurrence of posterior atrophy (PA) and medial temporal lobe atrophy (MTA) was correlated with cognitive and non-cognitive symptoms in Alzheimer's disease (AD) and mild cognitive impairment (MCI) patients are unclear. Methods Patients with probable AD and MCI from a medical center outpatient clinic received attention, memory, language, executive function evaluation and Mini-Mental Status Examination (MMSE). The severity of dementia was rated by the Clinical Dementia Rating (CDR) Sum of Box (CDR-SB). The neuropsychiatric inventory (NPI) subscale of agitation/aggression and mood symptoms was also applied. Magnetic resonance imaging (MRI) was scored visually for the MTA, PA and white matter hyperintensity (WMH) scores. Results We recruited 129 AD and 31MCI (mean age 78.8 years, 48%female) patients. MMSE scores, memory, language and executive function were all significantly decreased in individuals with AD than those with MCI (p <0.01). MTA and PA scores reflected significant atrophy in AD compared to MCI; however, theWMHscores did not differ. The MTA scores were significantly correlated with the frontal, parieto-occipital and globalWMHscores (p <0.01) whilethe PA scores showed a correlation with the parieto-occipital and temporalWMHscores (p <0.01). After adjusting for age, education, APOE4 gene and diagnostic group covariates, the MTA scores showed a significant association with MMSE and CDR-SB, while the right side PA scores were significantly associated with NPI-Agitation/aggression subscales (p <0.01). Conclusion Regional atrophy is related to different symptoms in patients with AD or MCI. PA score is useful as a complementary measure for non-cognitive symptom.