Brain atrophy rates predict subsequent clinical conversion in normal elderly and amnestic MCI
To test the hypothesis that the atrophy rate measured from serial MRI studies is associated with time to subsequent clinical conversion to a more impaired state in both cognitively healthy elderly subjects and in subjects with amnestic mild cognitive impairment (MCI). Ninety-one healthy elderly pati...
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| Veröffentlicht in: | Neurology 2005-10, Vol.65 (8), p.1227-1231 |
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| creator | JACK, C. R SHIUNG, M. M PETERSEN, R. C WEIGAND, S. D O'BRIEN, P. C GUNTER, J. L BOEVE, B. F KNOPMAN, D. S SMITH, G. E IVNIK, R. J TANGALOS, E. G |
| description | To test the hypothesis that the atrophy rate measured from serial MRI studies is associated with time to subsequent clinical conversion to a more impaired state in both cognitively healthy elderly subjects and in subjects with amnestic mild cognitive impairment (MCI).
Ninety-one healthy elderly patients and 72 patients with amnestic MCI who met inclusion criteria were identified from the Mayo Alzheimer's Disease Research Center and Alzheimer's Disease Patient Registry. Atrophy rates of four different brain structures--hippocampus, entorhinal cortex, whole brain, and ventricle--were measured from a pair of MRI studies separated by 1 to 2 years. The time of the second scan marked the beginning of the clinical observation period.
During follow-up, 13 healthy patients converted to MCI or Alzheimer disease (AD), whereas 39 MCI subjects converted to AD. Among those healthy at baseline, only larger ventricular annual percent volume change (APC) was associated with a higher risk of conversion (hazard ratio for a 1-SD increase 1.9, p = 0.03). Among MCI subjects, both greater ventricular volume APC (hazard ratio for a 1-SD increase 1.7, p < 0.001) and greater whole brain APC (hazard ratio for a 1-SD increase 1.4, p = 0.007) increased the risk of conversion to AD. Both ventricular APC (hazard ratio for a 1-SD increase 1.59, p = 0.001) and whole brain APC (hazard ratio for a 1-SD increase 1.32, p = 0.009) provided additional predictive information to covariate-adjusted cross-sectional hippocampal volume at baseline about the risk of converting from MCI to AD.
Higher whole brain and ventricle atrophy rates 1 to 2 years before baseline are associated with an increased hazard of conversion to a more impaired state. Combining a measure of hippocampal volume at baseline with a measure of either whole brain or ventricle atrophy rates from serial MRI scans provides complimentary predictive information about the hazard of subsequent conversion from mild cognitive impairment to Alzheimer disease. However, overlap among those who did vs those who did not convert indicate that these measures are unlikely to provide absolute prognostic information for individual patients. |
| doi_str_mv | 10.1212/01.wnl.0000180958.22678.91 |
| format | Article |
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Ninety-one healthy elderly patients and 72 patients with amnestic MCI who met inclusion criteria were identified from the Mayo Alzheimer's Disease Research Center and Alzheimer's Disease Patient Registry. Atrophy rates of four different brain structures--hippocampus, entorhinal cortex, whole brain, and ventricle--were measured from a pair of MRI studies separated by 1 to 2 years. The time of the second scan marked the beginning of the clinical observation period.
During follow-up, 13 healthy patients converted to MCI or Alzheimer disease (AD), whereas 39 MCI subjects converted to AD. Among those healthy at baseline, only larger ventricular annual percent volume change (APC) was associated with a higher risk of conversion (hazard ratio for a 1-SD increase 1.9, p = 0.03). Among MCI subjects, both greater ventricular volume APC (hazard ratio for a 1-SD increase 1.7, p < 0.001) and greater whole brain APC (hazard ratio for a 1-SD increase 1.4, p = 0.007) increased the risk of conversion to AD. Both ventricular APC (hazard ratio for a 1-SD increase 1.59, p = 0.001) and whole brain APC (hazard ratio for a 1-SD increase 1.32, p = 0.009) provided additional predictive information to covariate-adjusted cross-sectional hippocampal volume at baseline about the risk of converting from MCI to AD.
Higher whole brain and ventricle atrophy rates 1 to 2 years before baseline are associated with an increased hazard of conversion to a more impaired state. Combining a measure of hippocampal volume at baseline with a measure of either whole brain or ventricle atrophy rates from serial MRI scans provides complimentary predictive information about the hazard of subsequent conversion from mild cognitive impairment to Alzheimer disease. However, overlap among those who did vs those who did not convert indicate that these measures are unlikely to provide absolute prognostic information for individual patients.</description><identifier>ISSN: 0028-3878</identifier><identifier>ISSN: 1526-632X</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/01.wnl.0000180958.22678.91</identifier><identifier>PMID: 16247049</identifier><identifier>CODEN: NEURAI</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Age Factors ; Aged, 80 and over ; Aging - pathology ; Amnesia - diagnosis ; Amnesia - etiology ; Amnesia - physiopathology ; Atrophy - complications ; Atrophy - diagnosis ; Atrophy - physiopathology ; Biological and medical sciences ; Brain - pathology ; Brain - physiopathology ; Cohort Studies ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Disease Progression ; Entorhinal Cortex - pathology ; Entorhinal Cortex - physiopathology ; Female ; Hippocampus - pathology ; Hippocampus - physiopathology ; Humans ; Lateral Ventricles - pathology ; Lateral Ventricles - physiopathology ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis ; Neurology ; Predictive Value of Tests ; Time Factors</subject><ispartof>Neurology, 2005-10, Vol.65 (8), p.1227-1231</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c520t-abac66ec63920e1037949cd89b6ae19c2e3ac4d58fc9a4416186bbe16b5ee77b3</citedby><cites>FETCH-LOGICAL-c520t-abac66ec63920e1037949cd89b6ae19c2e3ac4d58fc9a4416186bbe16b5ee77b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,777,781,882,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17219940$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16247049$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>JACK, C. R</creatorcontrib><creatorcontrib>SHIUNG, M. M</creatorcontrib><creatorcontrib>PETERSEN, R. C</creatorcontrib><creatorcontrib>WEIGAND, S. D</creatorcontrib><creatorcontrib>O'BRIEN, P. C</creatorcontrib><creatorcontrib>GUNTER, J. L</creatorcontrib><creatorcontrib>BOEVE, B. F</creatorcontrib><creatorcontrib>KNOPMAN, D. S</creatorcontrib><creatorcontrib>SMITH, G. E</creatorcontrib><creatorcontrib>IVNIK, R. J</creatorcontrib><creatorcontrib>TANGALOS, E. G</creatorcontrib><title>Brain atrophy rates predict subsequent clinical conversion in normal elderly and amnestic MCI</title><title>Neurology</title><addtitle>Neurology</addtitle><description>To test the hypothesis that the atrophy rate measured from serial MRI studies is associated with time to subsequent clinical conversion to a more impaired state in both cognitively healthy elderly subjects and in subjects with amnestic mild cognitive impairment (MCI).
Ninety-one healthy elderly patients and 72 patients with amnestic MCI who met inclusion criteria were identified from the Mayo Alzheimer's Disease Research Center and Alzheimer's Disease Patient Registry. Atrophy rates of four different brain structures--hippocampus, entorhinal cortex, whole brain, and ventricle--were measured from a pair of MRI studies separated by 1 to 2 years. The time of the second scan marked the beginning of the clinical observation period.
During follow-up, 13 healthy patients converted to MCI or Alzheimer disease (AD), whereas 39 MCI subjects converted to AD. Among those healthy at baseline, only larger ventricular annual percent volume change (APC) was associated with a higher risk of conversion (hazard ratio for a 1-SD increase 1.9, p = 0.03). Among MCI subjects, both greater ventricular volume APC (hazard ratio for a 1-SD increase 1.7, p < 0.001) and greater whole brain APC (hazard ratio for a 1-SD increase 1.4, p = 0.007) increased the risk of conversion to AD. Both ventricular APC (hazard ratio for a 1-SD increase 1.59, p = 0.001) and whole brain APC (hazard ratio for a 1-SD increase 1.32, p = 0.009) provided additional predictive information to covariate-adjusted cross-sectional hippocampal volume at baseline about the risk of converting from MCI to AD.
Higher whole brain and ventricle atrophy rates 1 to 2 years before baseline are associated with an increased hazard of conversion to a more impaired state. Combining a measure of hippocampal volume at baseline with a measure of either whole brain or ventricle atrophy rates from serial MRI scans provides complimentary predictive information about the hazard of subsequent conversion from mild cognitive impairment to Alzheimer disease. However, overlap among those who did vs those who did not convert indicate that these measures are unlikely to provide absolute prognostic information for individual patients.</description><subject>Age Factors</subject><subject>Aged, 80 and over</subject><subject>Aging - pathology</subject><subject>Amnesia - diagnosis</subject><subject>Amnesia - etiology</subject><subject>Amnesia - physiopathology</subject><subject>Atrophy - complications</subject><subject>Atrophy - diagnosis</subject><subject>Atrophy - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Brain - pathology</subject><subject>Brain - physiopathology</subject><subject>Cohort Studies</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Disease Progression</subject><subject>Entorhinal Cortex - pathology</subject><subject>Entorhinal Cortex - physiopathology</subject><subject>Female</subject><subject>Hippocampus - pathology</subject><subject>Hippocampus - physiopathology</subject><subject>Humans</subject><subject>Lateral Ventricles - pathology</subject><subject>Lateral Ventricles - physiopathology</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</subject><subject>Neurology</subject><subject>Predictive Value of Tests</subject><subject>Time Factors</subject><issn>0028-3878</issn><issn>1526-632X</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkV1rFDEUhoNY7Fr9CxIEvZtpkpnJhxdCXfwoVLxR8EbCmcxZG8kkazJb2X9vahe3PTeBk-d9c3JeQl5y1nLBxTnj7Z8YWlaLa2YG3QohlW4Nf0RWfBCykZ34_pisGBO66bTSp-RpKb8qPghlnpBTLkWvWG9W5Me7DD5SWHLaXu9phgUL3WacvFto2Y0Ff-8wLtQFH72DQF2KN5iLT5FWXUx5rk0ME-awpxAnCnPEsnhHP68vn5GTDYSCzw_nGfn24f3X9afm6svHy_XFVeMGwZYGRnBSopOdEQw565TpjZu0GSUgN05gB66fBr1xBvqeS67lOCKX44Co1Nidkbd3vtvdOOPk6sQZgt1mP0Pe2wTePryJ_tr-TDdWqKEbelUNXh8McqofLoudfXEYAkRMu2KlVqJumlfwzR3ociol4-b_I5zZ23Qs47amY4_p2H_pWHMrfnF_zKP0EEcFXh0AKHXZmwzR-XLklODG9Kz7C9KqnG4</recordid><startdate>20051025</startdate><enddate>20051025</enddate><creator>JACK, C. R</creator><creator>SHIUNG, M. M</creator><creator>PETERSEN, R. C</creator><creator>WEIGAND, S. D</creator><creator>O'BRIEN, P. C</creator><creator>GUNTER, J. L</creator><creator>BOEVE, B. F</creator><creator>KNOPMAN, D. S</creator><creator>SMITH, G. E</creator><creator>IVNIK, R. J</creator><creator>TANGALOS, E. G</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20051025</creationdate><title>Brain atrophy rates predict subsequent clinical conversion in normal elderly and amnestic MCI</title><author>JACK, C. R ; SHIUNG, M. M ; PETERSEN, R. C ; WEIGAND, S. D ; O'BRIEN, P. C ; GUNTER, J. L ; BOEVE, B. F ; KNOPMAN, D. S ; SMITH, G. E ; IVNIK, R. J ; TANGALOS, E. G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c520t-abac66ec63920e1037949cd89b6ae19c2e3ac4d58fc9a4416186bbe16b5ee77b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Age Factors</topic><topic>Aged, 80 and over</topic><topic>Aging - pathology</topic><topic>Amnesia - diagnosis</topic><topic>Amnesia - etiology</topic><topic>Amnesia - physiopathology</topic><topic>Atrophy - complications</topic><topic>Atrophy - diagnosis</topic><topic>Atrophy - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Brain - pathology</topic><topic>Brain - physiopathology</topic><topic>Cohort Studies</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>Disease Progression</topic><topic>Entorhinal Cortex - pathology</topic><topic>Entorhinal Cortex - physiopathology</topic><topic>Female</topic><topic>Hippocampus - pathology</topic><topic>Hippocampus - physiopathology</topic><topic>Humans</topic><topic>Lateral Ventricles - pathology</topic><topic>Lateral Ventricles - physiopathology</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</topic><topic>Neurology</topic><topic>Predictive Value of Tests</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>JACK, C. R</creatorcontrib><creatorcontrib>SHIUNG, M. M</creatorcontrib><creatorcontrib>PETERSEN, R. C</creatorcontrib><creatorcontrib>WEIGAND, S. D</creatorcontrib><creatorcontrib>O'BRIEN, P. C</creatorcontrib><creatorcontrib>GUNTER, J. L</creatorcontrib><creatorcontrib>BOEVE, B. F</creatorcontrib><creatorcontrib>KNOPMAN, D. S</creatorcontrib><creatorcontrib>SMITH, G. E</creatorcontrib><creatorcontrib>IVNIK, R. J</creatorcontrib><creatorcontrib>TANGALOS, E. G</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>JACK, C. R</au><au>SHIUNG, M. M</au><au>PETERSEN, R. C</au><au>WEIGAND, S. D</au><au>O'BRIEN, P. C</au><au>GUNTER, J. L</au><au>BOEVE, B. F</au><au>KNOPMAN, D. S</au><au>SMITH, G. E</au><au>IVNIK, R. J</au><au>TANGALOS, E. G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Brain atrophy rates predict subsequent clinical conversion in normal elderly and amnestic MCI</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2005-10-25</date><risdate>2005</risdate><volume>65</volume><issue>8</issue><spage>1227</spage><epage>1231</epage><pages>1227-1231</pages><issn>0028-3878</issn><issn>1526-632X</issn><eissn>1526-632X</eissn><coden>NEURAI</coden><abstract>To test the hypothesis that the atrophy rate measured from serial MRI studies is associated with time to subsequent clinical conversion to a more impaired state in both cognitively healthy elderly subjects and in subjects with amnestic mild cognitive impairment (MCI).
Ninety-one healthy elderly patients and 72 patients with amnestic MCI who met inclusion criteria were identified from the Mayo Alzheimer's Disease Research Center and Alzheimer's Disease Patient Registry. Atrophy rates of four different brain structures--hippocampus, entorhinal cortex, whole brain, and ventricle--were measured from a pair of MRI studies separated by 1 to 2 years. The time of the second scan marked the beginning of the clinical observation period.
During follow-up, 13 healthy patients converted to MCI or Alzheimer disease (AD), whereas 39 MCI subjects converted to AD. Among those healthy at baseline, only larger ventricular annual percent volume change (APC) was associated with a higher risk of conversion (hazard ratio for a 1-SD increase 1.9, p = 0.03). Among MCI subjects, both greater ventricular volume APC (hazard ratio for a 1-SD increase 1.7, p < 0.001) and greater whole brain APC (hazard ratio for a 1-SD increase 1.4, p = 0.007) increased the risk of conversion to AD. Both ventricular APC (hazard ratio for a 1-SD increase 1.59, p = 0.001) and whole brain APC (hazard ratio for a 1-SD increase 1.32, p = 0.009) provided additional predictive information to covariate-adjusted cross-sectional hippocampal volume at baseline about the risk of converting from MCI to AD.
Higher whole brain and ventricle atrophy rates 1 to 2 years before baseline are associated with an increased hazard of conversion to a more impaired state. Combining a measure of hippocampal volume at baseline with a measure of either whole brain or ventricle atrophy rates from serial MRI scans provides complimentary predictive information about the hazard of subsequent conversion from mild cognitive impairment to Alzheimer disease. However, overlap among those who did vs those who did not convert indicate that these measures are unlikely to provide absolute prognostic information for individual patients.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>16247049</pmid><doi>10.1212/01.wnl.0000180958.22678.91</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Factors Aged, 80 and over Aging - pathology Amnesia - diagnosis Amnesia - etiology Amnesia - physiopathology Atrophy - complications Atrophy - diagnosis Atrophy - physiopathology Biological and medical sciences Brain - pathology Brain - physiopathology Cohort Studies Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Disease Progression Entorhinal Cortex - pathology Entorhinal Cortex - physiopathology Female Hippocampus - pathology Hippocampus - physiopathology Humans Lateral Ventricles - pathology Lateral Ventricles - physiopathology Magnetic Resonance Imaging Male Medical sciences Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis Neurology Predictive Value of Tests Time Factors |
| title | Brain atrophy rates predict subsequent clinical conversion in normal elderly and amnestic MCI |
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