Correlation between Clinical Dementia Rating and brain neuroimaging metrics of Alzheimer's disease: An observational study from a tertiary care institute of Eastern India

Context: Dementia is an already established major clinical health problem globally as well as in India. Neuroimaging, particularly magnetic resonance imaging (MRI), has an established role to support a clinical diagnosis of Alzheimer's disease (AD) by identifying certain brain atrophy patterns. Aims: The aim of this study was to assess clinico-radiological utility of neuroimaging biomarkers of AD. Settings and Design: This was an observational study with cross-sectional design with 36 patients of AD in a tertiary care hospital in Eastern India. Materials and Methods: Patients with AD in the age group of 55–90 years were subjected to MRI brain examination as per protocol at the Department of Radiodiagnosis, IPGMER and SSKM Hospital, Kolkata. The GCA (Global Cortical Atrophy) score, mesial temporal atrophy (MTA) score, Fazekas grading score, and Koedam score were determined and these MRI parameters were correlated statistically with Clinical Dementia Rating (CDR) score for further analysis. Statistical Analysis Used: IBM SPSS Statistics Version 20 was used as a statistical tool, and Spearman's rho coefficient was used as statistical test for correlation, and P < 0.05 was considered as statistically significant. Results: Average hippocampal volumes showed a significant negative correlation with CDR depicting a clinical deterioration, can be used as probable marker of brain atrophy. This is reinforced by the findings of significant positive correlations of CDR with GCA, MTA, and Koedam's score. Conclusions: It is proposed that global cortical atrophy, MTA, and Koedam score can be used as a basic screening imaging biomarker of AD in the population with dementia.