The clinical utility of the Four Mountains Test in the diagnosis of dementia : relationship to hippocampal and medial temporal lobe atrophy

• Main Author: Scanlon, Maura
• Published: University College London (University of London) 2017
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.747130

AIMS: The current study aimed to investigate the clinical utility of a spatial memory test (The Four Mountains Test; 4MT) in the determining dementia subtype. In a previous study, the 4MT did not find significant differences between Alzheimer’s (AD) and non-Alzheimer’s dementia. Structural MRI data was analysed to investigate if neurodegeneration in the hippocampus and medial temporal lobe structures accounted for these non-significant differences. METHOD: Data were extracted for fifteen memory clinic patients with dementia diagnoses (AD, vascular and mixed dementia). This included structural MRI scans, 4MT scores, and other neuropsychological measures. Freesurfer image analysis suite was used for automated analysis of the critical neuronal structures involved in AD. The relationships between volumetry, 4MT performance, and cognitive abilities was compared across diagnostic groups. RESULTS: Contrary to prediction, there were no positive associations between these variables. It was not possible to conduct statistical analysis to compare the AD, VaD, and the mixed dementia groups due to the restricted size of the final sample. Conclusions The clinical utility of the 4MT in distinguishing AD from other dementia types in heterogeneous groups of memory clinic patients has not been established. It is possible that overlapping patterns of atrophy and other cognitive impairments associated with dementia have a confounding impact on 4MT performance. However, the current study has low power and a lack of inferential statistics and as such the findings are tentative and must be interpreted with caution. However, the introduction of structural MRI data has contributed to further understanding of a tool that may support in the early diagnosis of dementia.