Detecting Primary Progressive Aphasia Atrophy Patterns: A Comparison of Visual Assessment and Quantitative Neuroimaging Techniques

Background: There are now clinically available automated MRI analysis software programs that compare brain volumes of patients to a normative sample and provide z-score data for various brain regions. These programs have yet to be validated in primary progressive aphasia (PPA).Objective: To address this gap in the literature, we examined Neuroreader™z-scores in PPA, relative to visual MRI assessment. We predicted that Neuroreader™1) would be more sensitive for detecting left?>?right atrophy in the cortical lobar regions in logopenic variant PPA clinical phenotype (lvPPA), and 2) would distinguish lvPPA (n?=?11) from amnestic mild cognitive impairment (aMCI; n?=?12).Methods: lvPPA or aMCI patients who underwent MRI with Neuroreader™were included in this study. Two neuroradiologists rated 10 regions. Neuroreader™lobar z-scores for those 10 regions, as well as a hippocampal asymmetry metric, were included in analyses.Results: Cohen’s Kappa coefficients were significant in 10 of the 28 computations (k?=?0.351 to 0.593, p=0.029). Neuroradiologists agreed 0% of the time that left asymmetry was present across regions. No significant differences emerged between aMCI and lvPPA in Neuroreader™z-scores across left or right frontal, temporal, or parietal regions (ps?>?0.10). There were significantly lower z-scores in the left compared to right for the hippocampus, as well as parietal, occipital, and temporal cortices in lvPPA.Conclusion: Overall, our results indicated moderate to low interrater reliability, and raters never agreed that left asymmetry was present. While lower z-scores in the left hemisphere regions emerged in lvPPA, Neuroreader™failed to differentiate lvPPA from aMCI.