Mohammed T. Abou-Saleh

ANATOMY OF THE AGING BRAIN 27Table 7.2.Aging and changes in size of brain parenchymaStudy Subjects Imaging and measurement technique FindingsHaug 1977 18Jacoby et al., 1980 19Cala et al., 1981 20Zatz et al., 1982 12Gado et al., 1983 14170 Scans 0–75 years old.Subjects with ‘normal neurologicalfindings’ complaining of headaches50 Healthy elderly volunteers,62–88 years old, 10 M, 40 F. Nohistory of significant psychiatric orneurologic illness. Handedness notspecified115 Volunteers, 15–40 years old,62 M, 53 F. No history of migraine,head trauma, or excessive alcohol intake(no additional details provided). All buteight subjects right-handed123 Normal volunteers, 20–90 yearsold. Unequal sex distributions amongdifferent age groups, with more womenin the old group. Excluded: history ofneurological problems or major medicaldiseases12 normal volunteers 64–81 years old.Excluded: subjects with dementiaGomori et al., 1984 21 148 Neurologically intact patients(subjects with minor neurologicalsymptoms and patients with lung,breast, prostate or colon cancer butno CNS involvement. All subjects hadnormal neurological examinations),28–84 years oldLaffey et al., 1984 11212 Normal volunteers livingindependently, 65 years old andolder. Sex distribution same in all groups(52% M, 48% F). Excluded: alcoholismand history or findings of neurologicalillnessSchwartz et al., 30 Healthy male volunteers 21–81 years1985 5 old. No history of major medical,neurologic or psychiatric illness.Handedness not specifiedPfefferbaum et al., 57 Normal volunteers 20–84 years old,1986 13 27 M, 30 FStafford et al., 79 Normal male volunteers, 31–871988 22 years old. Excluded: alcoholism,psychiatric illness, learning disability,severe head trauma, epilepsy, hypertension,chronic lung disease, renaldisease, coronary artery disease, cancerGolomb et al., 154 Healthy volunteers with MMSE>27,1993 23 55–88 years old (70+8 years), 73 M,81 F. No evidence of active medical,neurologic, or psychiatric illness.Handedness not specifiedCT, linear (maximum width ofinterhemispheric fissure)CT. Ratings (four-point scale) of corticalatrophy from films by single blindedrater; five regions rated (frontal, parietal,temporal, insular and occipital) andscores summedCT (n=two scanners). Ratings (fivepointscale) of cortical atrophy (noadditional details provided). Axial slices(13 mm thick)CT. Planimetry (sulcal fluid area in twosupraventricular slices divided by cranialsize). Volumetric (total fluid volume intemporo-Sylvian area divided by totalcranial volume). Axial slices (n=9)10 mm thick, with 10 mm interscan gap;lowest slice at the level just above thepetrous pyramids and orbital roofsCT. Sulcal volumetric ratio (ratio ofsulcal to cranial volume). Axial slices(n=7), including three sections abovethe roof of the lateral ventricle andfour below itCT. Linear (cortical sulci ratio, frontalinterhemispheric fissure ratio, Sylvianfissure ratio)CT. Qualitative rating (five-point scale)of cortical atrophy by two experiencedradiologists. Axial slice at the midventricularlevelCT. Volume measurements derived fromcomputer-assisted segmentation technique(ASI-II program). Axial slices (n=7)starting from the plane of the inferiororbitomeatal line (10 mm thick, 7 mminterscan gap)CT. Sulcal volumetric ratio (ratio of totalsulcal volume to total cranial volume).Axial slices (n=12) with 8 mm interscangap, starting from the level of thesuperior roof of the orbit and proceedingupwardsCT. Planimetry: ratio of cortical sulcalarea to cranial area. Axial slice atsupraventricular levelsCortical atrophy increased with age;width of interhemispheric fissureincreased approximately 5-fold(0.5–2.8 mm) from age 16–30 to age61–75, in a continuous fashionAge correlated with total cortical atrophyscore. Interactions with sex or lateralitynot reported. Adjusting for age, norelation between any CT measure andperformance on the Hodkinson test ofmemory and orientationAge apparently associated with increasedfrequency of mild (grade 2) atrophy offrontal lobes and cerebellar vermis, butno statistical analysis reported. Interactionswith sex or laterality not reportedIncreased cortical atrophy with age. Area ofsulcal fluid in supraventricular levels wasstable until the seventh decade thenincreased four-fold from age 60 to 80+Volume of fluid in temporo-Sylvian areawas stable until age 60; then increased by30% from age 60 to age 80+Increased cortical atrophy with age; corticalsulcal volume ratio increased by 13.3% in1 year follow-upCortical atrophy increased with age; agecorrelated with Sylvian fissure, interhemisphericfissure and cortical sulciratios (r=0.53, 0.4 and 0.2, respectively).Sylvian fissure ratio increased 1.6-foldbetween ages 28–49 and 80–84 continuously;interhemispheric fissure ratioincreased five-fold across the same agegroups continuouslyTrend (not significant) for increased corticalatrophy with age; mean rating of 0.83 atage 65–69 to 1.4 at age 80–89. Malesshowed higher scores for cortical atrophyin all age groupsAdjusting for intracranial volume (IV), agenegatively correlated with volume of graymatter and with volume of gray pluswhite matter, but not with white mattervolume. Subjects more than 60 years old(n=11) had smaller volumes of thalamus,lenticular nuclei and total gray matterthan younger subjects (n=19). Effectssimilar for both hemispheresIncreased cortical atrophy with age; volumeratio increased seven-fold from the thirdto the eighth decade. The increase wasfaster after age 60Cortical atrophy increased with age;cortical sulci area ratio increased1.8-fold between ages 30–39 and 70+(0.012–0.022), faster after the sixthdecadeCT (n=51); MR imaging (n=81); both Subjects with hippocampal atrophy (ratingCT and MR imaging (n=22). Blinded of 2 or greater in either hemisphere;ratings (4-point scale) of hippocampal n=50) significantly older than thoseatrophy as defined by dilatation of without atrophy. More males (41%) thantransverse choroidal fissure on films, by females (25%) with hippocampal atrophyraters (n=?) with established reliabilitiescontinues overleaf