Clinical relevance of brain atrophy subtypes categorization in memory clinics.

Planche, Vincent; Bouteloup, Vincent; Mangin, Jean-François; Dubois, Bruno; Delrieu, Julien; Pasquier, Florence; Blanc, Frédéric; Paquet, Claire; Hanon, Olivier; Gabelle, Audrey; Ceccaldi, Matthieu; Annweiler, Cédric; Krolak-Salmon, Pierre; Habert, Marie-Odile; Fischer, Clara; Chupin, Marie; Béjot, Yannick; Godefroy, Olivier; Wallon, David; Sauvée, Mathilde; Bourdel-Marchasson, Isabelle; Jalenques, Isabelle; Tison, François; Chêne, Geneviève; Dufouil, Carole

INTRODUCTION The clinical relevance of brain atrophy subtypes categorization in non-demented persons without a priori knowledge regarding their amyloid status or clinical presentation is unknown. METHODS A total of 2083 outpatients with either subjective cognitive complaint or mild cognitive impairment at study entry were followed during 4 years (MEMENTO cohort). Atrophy subtypes were defined using baseline magnetic resonance imaging (MRI) and previously described algorithms. RESULTS Typical/diffuse atrophy was associated with faster cognitive decline and the highest risk of developing dementia and Alzheimer's disease (AD) over time, both in the whole analytic sample and in amyloid-positive participants. Hippocampal-sparing and limbic-predominant atrophy were also associated with incident dementia, with faster cognitive decline in the limbic predominant atrophy group. Lewy body dementia was more frequent in the hippocampal-sparing and minimal/no atrophy groups. DISCUSSION Atrophy subtypes categorization predicted different subsequent patterns of cognitive decline and rates of conversion to distinct etiologies of dementia in persons attending memory clinics.