Dataset Information

Risk estimation before progression to mild cognitive impairment and Alzheimer's disease: an AD resemblance atrophy index.

ABSTRACT: To realize an individual-level risk evaluation of progression of early Alzheimer's disease (AD), we applied an AD resemblance atrophy index (AD-RAI) to differentiate the subjects at risk of progression from normal subjects (NC) to mild cognitive impairment (MCI) and from MCI to AD. We included 183 subjects with a two-year follow-up: 50 NC stable (NCs), 23 NC-to-MCI converters (NCc), 50 MCI stable (MCIs), 35 MCI-to-AD converters (MCIc), 25 AD stable (ADs). ANCOVA analyses were used to identify baseline brain atrophy in converters compared with non-converters. To explore the relative merits of AD-RAI over individual regional volumetric measures in prediction of disease progression, we searched for the optimal cutoff for each measure in logistic regressions and plotted the longitudinal trajectories of these brain volumetric measures in converters and non-converters. Baseline AD-RAI performed the best in differentiating NCc from NCs (odds ratio 26.35, AUC 0.740) and MCIc from MCIs (odds ratio 8.91, AUC 0.771). The AD-RAI presented greater increase in the second year for NCc vs. NCs but not for MCIc vs. MCIs. Baseline AD-RAIs were also associated with CSF-based and PET-based AD biomarkers. These results showed the potential of AD-RAI in early risk estimation before progression to MCI/AD at an individual-level.

SUBMITTER: Zhao L

PROVIDER: S-EPMC6738429 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Risk estimation before progression to mild cognitive impairment and Alzheimer's disease: an AD resemblance atrophy index.

Zhao Lei L Luo Yishan Y Lew Darson D Liu Wenyan W Au Lisa L Mok Vincent V Shi Lin L

Aging 20190829 16

To realize an individual-level risk evaluation of progression of early Alzheimer's disease (AD), we applied an AD resemblance atrophy index (AD-RAI) to differentiate the subjects at risk of progression from normal subjects (NC) to mild cognitive impairment (MCI) and from MCI to AD. We included 183 subjects with a two-year follow-up: 50 NC stable (NCs), 23 NC-to-MCI converters (NCc), 50 MCI stable (MCIs), 35 MCI-to-AD converters (MCIc), 25 AD stable (ADs). ANCOVA analyses were used to identify ba ...[more]

PMID: 31467257

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Project description:BackgroundAutomated tools for characterising dementia risk have the potential to aid in the diagnosis, prognosis, and treatment of Alzheimer's disease (AD). Here, we examined a novel machine learning-based brain atrophy marker, the AD-resemblance atrophy index (AD-RAI), to assess its test-retest reliability and further validate its use in disease classification and prediction.MethodsAge- and sex-matched 44 probable AD (Age: 69.13 ± 7.13; MMSE: 27-30) and 22 non-demented control (Age: 69.38 ± 7.21; MMSE: 27-30) participants were obtained from the Minimal Interval Resonance Imaging in Alzheimer's Disease (MIRIAD) dataset. Serial T1-weighted images (n = 678) from up to nine time points over a 2-year period, including 179 pairs of back-to-back scans acquired on same participants on the same day and 40 pairs of scans acquired at 2-week intervals were included. All images were automatically processed with AccuBrain® to calculate the AD-RAI. Its same-day repeatability and 2-week reproducibility were first assessed. The discriminative performance of AD-RAI was evaluated using the receiver operating characteristic curve, where DeLong's test was used to evaluate its performance against quantitative medial temporal lobe atrophy (QMTA) and hippocampal volume adjusted by intracranial volume (ICV)-proportions and ICV-residuals methods, respectively (HVR and HRV). Linear mixed-effects modelling was used to investigate longitudinal trajectories of AD-RAI and baseline AD-RAI prediction of cognitive decline. Finally, the longitudinal associations between AD-RAI and MMSE scores were assessed.ResultsAD-RAI had excellent same-day repeatability and excellent 2-week reproducibility. AD-RAI's AUC (99.8%; 95%CI = [99.3%, 100%]) was equivalent to that of QMTA (96.8%; 95%CI = [92.9%, 100%]), and better than that of HVR (86.8%; 95%CI = [78.2%, 95.4%]) or HRV (90.3%; 95%CI = [83.0%, 97.6%]). While baseline AD-RAI was significantly higher in the AD group, it did not show detectable changes over 2 years. Baseline AD-RAI was negatively associated with MMSE scores and the rate of the change in MMSE scores over time. A negative longitudinal association was also found between AD-RAI values and the MMSE scores among AD patients.ConclusionsThe AD-RAI represents a potential biomarker that may support AD diagnosis and be used to predict the rate of future cognitive decline in AD patients.

Dataset Information

Risk estimation before progression to mild cognitive impairment and Alzheimer's disease: an AD resemblance atrophy index.

Publications

Risk estimation before progression to mild cognitive impairment and Alzheimer's disease: an AD resemblance atrophy index.

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