Assessment of brain cortical atrophy in neurodegenerative as well as selected neurological disorders – assessment methods and significance in diagnosis

Neurodegenerative disorders are heterogeneous with respect to aetiology and symptoms but they are all characterised by an irreversible functional impairment of the central nervous system due to acquired or hereditary conditions. Most commonly, neurodegenerative disorders lead to cognitive impairment, including dementia, and different motor disturbances. Although neurodegenerative disorders typically affect elderly patients, they are not caused by normal aging of the brain. Among the many pathological changes observed in neurodegenerative disorders, cortical atrophy is found most commonly, and it can be observed in characteristic patterns. Advanced neuroimaging methods allow for an in vivo assessment of both the localisation and severity of brain atrophy.

Currently, quantitative brain structural assessment is based on brain magnetic resonance or computed tomography with thin-layer images, which can be assessed traditionally by visual analysis or with special computer software. For the visual analysis, standardised scales are used most commonly. Computer software enables automatic conversion of images, their comparison with appropriate templates, and graphical and/or quantitative analysis.

These methods help differentiate neurodegenerative changes from those found in normal brain aging and assist in monitoring disease progression as well as treatment response. Herein, we present the currently available methods for assessing brain atrophy with their applications in clinical neurology.