Modified Visual Magnetic Resonance Rating Scale for Evaluation of Patients with Forgetfulness

Abstract

BackgroundAs cognitive impairment increases with age, sulcal atrophy (SA) and the enlargement of the ventricles also increase. Considering the measurements on the previously proposed visual scales, a new scale is proposed in this study that allows us to evaluate the atrophy, white matter hyperintensities (WMHs), basal ganglia infarct (BGI), and infratentorial infarct (ITI) together. Our aim of this study is to propose a practical and standardized MRI for the clinicians to be used in daily practice.MethodsA total of 97 patients older than 60 years and diagnosed with depression or Alzheimer’s disease (AD) are included. Cranial MRI, Mini Mental State Examination (MMSE), detailed neuropsychometric tests, and depression scales are applied to all patients. The SA, ventricular atrophy (VA), medial temporal lobe atrophy (MTA), periventricular WMH (PWMH), subcortical WMH (SCWMH), BGI, and ITI are scored according to the scale. The total score is also recorded.ResultsThe average age of the patients was 74.53, and the mean MMSE score was 22.7 in the degenerative group and 27.8 in the non-degenerative group. Among the patients, 50 were diagnosed with AD. All parameters significantly increased with age. In the degenerative group, SA, VA, MTA, PWMH, SCWMH, and total scores were found to be significantly higher. Sensitivities of VA, PWMH, SCWMH, and total scores, as well as both sensitivity and specificities of MTA score, were observed to be high. When they were combined, sensitivities and specificities were found to be high.ConclusionThe scale is observed to be predictive in discriminating degenerative and non-degenerative processes. This discrimination is important, particularly in depressive patients complaining of forgetfulness.

Differentiating MCI from depression through verbal memory scores

“…The MVMRS was created by Yalciner et al based on the combined measurement of atrophy, WMH, BGI, and ITI, 13 with a high ability to discriminate MDD from MCI and high interrater reliability in the Turkish population, making this multi-modal tool a strong candidate to provide a practical and standardized MRI for clinicians in daily practice. 13 It is also worth noting that evaluating the interrater reliability of magnetic resonance visual assessment using the MVMRS between two neurologists and a radiologist has resulted in results ranging from good to excellent. 16 The details of the MVMRS are shown in Table 1.…”

“…Our main aim was to show the utility of the MVMRS and cognitive tests in distinguishing MDD from MCI and to evaluate the predictive role of the existence of MDD and/or depressive symptoms in MCI based on our previous work that indicated the value of the MVMRS for patients with forgetfulness. Our hypothesis was suggested by Yalcin et al.’s observation that the MVMRS is a useful scale for discriminating patients with Alzheimer's dementia and depressive patients 13 …”

“…The MVMRS has been developed by Yalciner et al. as a scale that evaluates the atrophy, white matter hyperintensities (WMHs), basal ganglia infarct (BGI), and infratentorial infarct (ITI) together for proposing a practical and standardized MRI for the clinicians to be used in daily practice 13 . In this study, we used the MVMRS for detecting levels of WMHs, ventricular atrophy (VA), and parahippocampal atrophy, which were applied to differentiate MDD from MCI in the study population.…”

“…Our hypothesis was suggested by Yalcin et al.’s observation that the MVMRS is a useful scale for discriminating patients with Alzheimer's dementia and depressive patients. 13 …”

Modified Visual Magnetic Resonance Scale and Neuropsychometric Corelations in Alzheimer's disease

“…Yalçıner ve ark. tarafından geliştirilen ve atrofi, ak madde hasarı, bazal gangliyon ve infratentoryal bölgelerdeki infarktların görsel olarak değerlendirilmesine dayanan "Modifiye Görsel Manyetik Rezonans Derecelendirme Skalası" (MGMRDS), yukarıda değinilen pek çok farklı skalanın ve ayrıca demans tanısında kullanılan görsel skalaların kombinasyonundan oluşmaktadır (20).…”