Normal versus pathological findings in the aging brain - is age just a number?

Congress:

ECR 2020

Poster Number:

C-02448

Type:

Educational Exhibit

Keywords:

Ischaemia / Infarction, Dementia, Staging, MR, CT, Neuroradiology brain, CNS, Neuro, Not applicable

Authors:

T. Lorga¹, C. Casimiro², I. Gil²; ¹Lisbon/PT, ²Lisboa/PT

DOI:

10.26044/ecr2020/C-02448

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-02448

Fig. 1: Global Cortical Atrophy (GCA) score 1. The opening of sulci suggests a pattern...

Fig. 2: MTA score 0. Normal width of the choroid fissures and of the temporal horns....

Fig. 3: MTA score 2. Moderate widening of the choroid fissure and mild widening of the...

Fig. 4: Koedam score 1. Mild cingulate and parieto-occipital sulcus widening with mild...

Learning objectives

1. To describe typical structural brain changes seen in normal aging 2. To illustrate radiological findings often overlooked on neuroimaging studies of normal brain aging 3. To differentiate between normal brain aging and abnormal findings

Background

The aging process of the brain involves an array of multifactorial events such as mitochondrial dysfunction, cellular aging, neuronal death, and genetic, environmental and lifestyle factors. It can have functional consequences or be a process where cognition remains unimpaired, thus the aging brain’s typical changes are closely related to those of neurodegeneration. It is postulated that these two different entities may form a spectrum as there is considerable overlap between patterns of brain pathology in aging and neurodegenerative disease. The findings of the aging brain...

Findings and procedure details

BRAIN ATROPHY Brain volume declines normally with aging at a certain rate due to atrophy of both grey and white matter. Loss of myelin, neuronal cell death and axonal degeneration cause a gradual loss of total brain volume that begins as early as the age of 30 (at a rate of 0.2% per year). After the age of 70 this loss is more substantial as the rate rises up to 0.5% per year (5% per decade). Although automated volumetry to assess quantitatively if brain atrophy...

Conclusion

Recognizing age-related brain changes is crucial to assess normality and to exclude patterns of neurodegenerative diseases. Findings are often overlooked and the evaluation of normal structural versus pathological brain aging can be challenging.

Personal information and conflict of interest

T. Lorga; Lisbon/PT - nothing to disclose C. Casimiro; Lisbon/PT - nothing to disclose I. Gil; Lisbon/PT - nothing to disclose

References

Haller S, Vernooij MW, Kuijer JPA, Larsson EM, Jäger HR, Barkhof F. Cerebral Microbleeds: Imaging and Clinical Significance. Radiology. 2018;287(1):11–28. Koedam EL, Lehmann M, van der Flier WM, et al. Visual assessment of posterior atrophy development of a MRI rating scale.Eur Radiol. 2011;21(12):2618–2625. Scheltens P, Leys D, Barkhof F, Huglo D, Weinstein HC, Vermersch P, Kuiper M, Steinling M, Wolters EC, Valk J. Atrophy of medial temporal lobes on MRI in "probable" Alzheimer's disease and normal ageing: diagnostic value and neuropsychological correlates. J. Neurol. Neurosurg....