5 Medial Temporal Atrophy (MTA)

To visually assess the focal atrophy of the temporal lobe we utilize the 5-step “medial temporal lobe atrophy (MTA) score”. All scorings should be done on slices perpendicular to the long axis of the hippocampus on the first slice posterior to the amygdala. The MTA score increases as a function of age.
In the Nor-COAST study the Scheltens scale (Scheltens et al. 1992) will be used. The sensitivity and specificityof the visual Scheltens scale is comparable to automatic computational evalutations (Westman et al. 2011). “The Radiologyassistant” gives a compact summary of the Scheltens scale.

Score	Meaning
0	Normal width of choroid fissure, temporal horn and height of hippocampus
1	Mild widening of the choroid fissure while still normal temporal horn and hippocampus
2	Moderate widening of the choroid fissure, mild widening of the temporal horn and slightly decreased height of the hippocampus
3	severe widening of the choroid fissure, moderate widening of the temporal horn and moderate decreased height of hippocampus
4	severe widening of choroid fissure and temporal horn and severely decreased height of hippocampus

As a simplified scale one could use whether or not a medial temporal lobe atrohpy is present:

Score	Meaning
0	No MTA
1	MTA grade 1 - 4

References

Scheltens, P, D Leys, F Barkhof, D Huglo, H C Weinstein, P Vermersch, M Kuiper, M Steinling, E C Wolters, and J Valk. 1992. “Atrophy of medial temporal lobes on MRI in probable Alzheimer’s disease and normal ageing: diagnostic value and neuropsychological correlates.” Journal of Neurology, Neurosurgery, and Psychiatry 55 (10). BMJ Group: 967–72. http://www.ncbi.nlm.nih.gov/pubmed/1431963.

Westman, Eric, Lena Cavallin, J-Sebastian Muehlboeck, Yi Zhang, Patrizia Mecocci, Bruno Vellas, Magda Tsolaki, et al. 2011. “Sensitivity and specificity of medial temporal lobe visual ratings and multivariate regional MRI classification in Alzheimer’s disease.” PloS One 6 (7). Public Library of Science: e22506. doi:10.1371/journal.pone.0022506.