Reduced Pineal Volume in Alzheimer Disease: A Retrospective Cross-sectional MR Imaging Study

Abstract

Purpose To evaluate pineal volume in patients with Alzheimer disease (AD), patients with mild cognitive impairment (MCI), and healthy control subjects and to correlate the findings with results of cognitive testing and brain parenchymal volumes. Materials and Methods The ethics committee approved this retrospective study. The participants included 63 patients with AD, 33 patients with MCI, and 24 healthy control subjects. There were 36 men and 84 women, with a mean age (±standard deviation) of 76.7 years ± 7.6. The pineal gland volume and pineal parenchymal volume were measured by using three-dimensional volumetric magnetic resonance imaging (T1-weighted magnetization-prepared rapid gradient-echo sequence; spatial resolution, 0.9 × 0.98 × 0.98 mm). With age and total intracranial volume as covariates, analysis of covariance with the Bonferroni post hoc test was performed to compare the pineal volume among the AD, MCI, and control groups. Multiple regression analyses were used to identify predictor variables associated with pineal volume. Results The mean pineal gland volume in patients with AD (72.3 mm ± 5.4; 95% confidence interval [CI]: 61.5 mm, 83.1 mm) was significantly smaller than that in control subjects (102.1 mm ± 9.0; 95% CI: 84.4 mm, 119.9 mm) (P = .019). The mean pineal parenchymal volume in patients with AD (63.8 mm ± 4.2; 95% CI: 55.4 mm, 72.1 mm) was significantly smaller than that in patients with MCI (81.7 mm ± 5.8; 95% CI: 70.3 mm, 93.1 mm; P = .044) and control subjects (89.1 mm ± 6.9; 95% CI: 75.4 mm, 102.9 mm; P = .009). Multiple regression analyses demonstrated that the Mini-Mental State Examination score and total intracranial volume were significant independent predictors of both pineal gland volume and pineal parenchymal volume (P < .001). Conclusion Pineal volume reduction showed correlation with cognitive decline and thus might be useful to predict cognitive decline in patients with AD. RSNA, 2017.

Neural Correlates of Sleep Disturbance in Alzheimer’s Disease: Role of the Precuneus in Sleep Disturbance

“…A retrospective cross-sectional study was performed in 63 patients with AD who were also included in a previous study [ 7 ]. The inclusion criteria were 1) no use of antidementia or psychoactive drugs; 2) no significant history of psychiatric or neurological disorders (except AD), including stroke, cerebral hemorrhage, head injury, epilepsy, psychiatric disorders, alcohol abuse or a serious medical condition; 3) brain magnetic resonance imaging (MRI) performed before medication; 4) evaluation using the Mini-Mental State Examination (MMSE) [ 12 ] and Neuropsychiatric Inventory (NPI) [ 13 ] before the start of medication; and 5) meeting the National Institute of Neurological and Communicative Disease and Stroke-Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) criteria for probable AD [ 14 ].…”

“…Pineal gland volume (PGV) and pineal parenchymal volume (PPV) were measured as in previous studies [ 7, 8, 15–18 ]. The pineal gland was identified using the reconstructed axial MP-RAGE slice.…”

“…blinded to the clinical data measured PGV, PPV, PVH, and DWMH in all subjects. In our previous study [ 7 ], 14 randomly selected subjects were reassessed after at least four weeks by the same rater (T.M.). Another rater (A.I.)…”

“…Sleep disturbance in AD may be associated with physiological alterations in the suprachiasmatic nucleus (SCN) and pineal gland [ 6 ]. Recently, melatonin has attracted attention as a cause of AD pathology, and we have shown that the volume of the pineal gland, which is the only organ that secretes melatonin, is significantly smaller in patients with AD than in those with mild cognitive impairment (MCI) and healthy controls [ 7 ]. Since the pineal volume is also small in patients with primary insomnia [ 8 ], we hypothesized that the pineal volume in patients with AD with sleep disturbance might be smaller than in those without sleep disturbance.…”

Insufficient Leiomyoma Infarction in Uterine Artery Embolization: Relationship with Tumor Location

“…Baseline Characteristics and Technical Outcomes Values are presented as mean ± SD for continuous variables and frequencies for categorical variables with percentages in parentheses. The definition of the dominant tumor location is shown in Figure 1a-c. OAE ¼ ovarian artery embolization; UFS-QOL ¼ Uterine Fibroid Symptom and Quality of Life.total leiomyoma volume per case, the sample size of cases was estimated to be 14 with R software (R Foundation for Statistical Computing, Vienna, Austria) under the following conditions: calculated sample size for the hypothesized value r, 0.90; null hypothesis r0, 0.60; number of ratings, 2; desired a, .05; number of tails, 2; desired power, .80(22,23).Reader 2 independently interpreted data in a blind manner and measured the number of tumors, uterine volumes, and infarction rates of total leiomyoma volume using 14 randomly selected cases. Regarding individual leiomyomas in all cases, the sample size of tumors was estimated to be 49 with the same software under the following conditions: calculated sample size for the hypothesized value r, 0.80; null hypothesis r0, 0.60; number of ratings, 2; desired a, .05; number of tails, 2; desired power, .80(22,23).…”