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Identifying cognitively healthy elderly individuals with subsequent memory decline by using automated MR temporoparietal volumes.

ABSTRACT: To determine whether automated temporoparietal brain volumes can be used to accurately predict future memory decline among a multicenter cohort of cognitively healthy elderly individuals.The study was approved by the institutional review board at each site and was HIPAA compliant, with written consent obtained from all participants. One hundred forty-nine cognitively healthy study participants were recruited through the Alzheimer's Disease Neuroimaging Initiative and underwent a standardized baseline 1.5-T magnetic resonance (MR) imaging examination, as well as neuropsychological assessment at baseline and after 2 years of follow-up. A composite memory score for the 2-year change in the results of two delayed-recall tests was calculated, and memory decline was defined as a composite score that was at least 1 standard deviation below the group mean score. The predictive accuracy of the brain volumes was estimated by using areas under receiver operating characteristic curves and was further assessed by using leave-one-out cross validation.Use of the most accurate region model, which included the hippocampus; parahippocampal gyrus; amygdala; superior, middle, and inferior temporal gyri; superior parietal lobe; and posterior cingulate gyrus, resulted in a fitted accuracy of 94% and a cross-validated accuracy of 81%.Study results indicate that automated temporal and parietal volumes can be used to identify with high accuracy cognitively healthy individuals who are at risk for future memory decline. Further validation of this predictive model in a new cohort is required.

SUBMITTER: Chiang GC

PROVIDER: S-EPMC3099048 | biostudies-other | 2011 Jun

REPOSITORIES: biostudies-other

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Project description:Among cognitively normal individuals, elevated brain amyloid (defined by cerebrospinal fluid assays or positron emission tomography regional summaries) can be related to risk for later Alzheimer-related cognitive decline.To characterize and quantify the risk for Alzheimer-related cognitive decline among cognitively normal individuals with elevated brain amyloid.Exploratory analyses were conducted with longitudinal cognitive and biomarker data from 445 cognitively normal individuals in the United States and Canada. Participants were observed from August 23, 2005, to June 7, 2016, for a median of 3.1 years (interquartile range, 2.0-4.2 years; maximum follow-up, 10.3 years) as part of the Alzheimer's Disease Neuroimaging Initiative (ADNI).Individuals were classified at baseline as having normal (n?=?243) or elevated (n?=?202) brain amyloid using positron emission tomography amyloid imaging or a cerebrospinal fluid assay of amyloid ?.Outcomes included scores on the Preclinical Alzheimer Cognitive Composite (PACC; a sum of 4 baseline standardized z scores, which decreases with worse performance), Mini-Mental State Examination (MMSE; 0 [worst] to 30 [best] points), Clinical Dementia Rating Sum of Boxes (CDR-Sum of Boxes; 0 [best] to 18 [worst] points), and Logical Memory Delayed Recall (0 [worst] to 25 [best] story units).Among the 445 participants (243 with normal amyloid, 202 with elevated amyloid), mean (SD) age was 74.0 (5.9) years, mean education was 16.4 (2.7) years, and 52% were women. The mean score for PACC at baseline was 0.00 (2.60); for MMSE, 29.0 (1.2); for CDR-Sum of Boxes, 0.04 (0.14); and for Logical Memory Delayed Recall, 13.1 (3.3). Compared with the group with normal amyloid, those with elevated amyloid had worse mean scores at 4 years on the PACC (mean difference, 1.51 points [95% CI, 0.94-2.10]; P?<?.001), MMSE (mean difference, 0.56 points [95% CI, 0.32-0.80]; P?<?.001), and CDR-Sum of Boxes (mean difference, 0.23 points [95% CI, 0.08-0.38]; P?=?.002). For Logical Memory Delayed Recall, between-group score was not statistically significant at 4 years (mean difference, 0.73 story units [95% CI, -0.02 to 1.48]; P?=?.056).Exploratory analyses of a cognitively normal cohort followed up for a median of 3.1 years suggest that elevation in baseline brain amyloid level, compared with normal brain amyloid level, was associated with higher likelihood of cognitive decline, although the findings are of uncertain clinical significance. Further research is needed to assess the clinical importance of these differences and measure longer-term associations.

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Identifying cognitively healthy elderly individuals with subsequent memory decline by using automated MR temporoparietal volumes.

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