Diagnostic power of default mode network resting state fMRI in the detection of Alzheimer's disease
Diagnostic power of default mode network resting state fMRI in the detection of Alzheimer's disease
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DOI：
10.1016/j.neurobiolaging.2010.04.013
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发表时间：
2012-03-01
影响因子：
4.2
通讯作者：
Meindl, Thomas
中科院分区：
文献类型：
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作者：
Koch, Walter;Teipel, Stephan;Meindl, Thomas
静息状态下默认模式网络(DMN)脑活动的功能磁共振成像(FMRI)作为诊断早期阿尔茨海默病的一种潜在的非侵入性生物标志物，最近受到了人们的关注。这项研究的目的是确定哪种数据处理方法提供最高的诊断能力，并定义衡量标准，以进一步优化诊断价值。对21名健康受试者、17名轻度认知障碍受试者和15名阿尔茨海默病(AD)患者进行功能磁共振成像，并用基于感兴趣体积(VOI)的信号时程评估和独立成分分析(ICA)对数据进行评估。第一种方法确定DMN区域的互联量(用相关系数表示)；第二种方法确定DMN共激活的大小。受检者中有41人有载脂蛋白E(ApoE)基因分型。在独立成分分析中，单个DMN区域数据的诊断能力(以准确度表示)分别为%，两个DMN区域间时间进程的单一相关性的诊断能力为71%。多变量分析结合分析方法和不同地区的数据，准确率可提高到97%(敏感度100%，特异度95%)。在非痴呆受试者中，载脂蛋白E epsilon 4等位基因携带者和非载脂蛋白E epsilon 4等位基因携带者在DMN内的活性没有显著差异。然而，有一些迹象表明，如果样本较大，功能磁共振成像可能会提供有用的信息。在识别阿尔茨海默病患者方面，时间进程相关分析似乎优于独立成分分析。然而，通过考虑DMN不同部分的活动以及这些区域之间的相互连接，结合两种分析方法的多变量分析是获得最佳和临床可接受的诊断能力所必需的。(C)2012 Elsevier Inc.保留所有权利。
Functional magnetic resonance imaging (fMRI) of default mode network (DMN) brain activity during resting is recently gaining attention as a potential noninvasive biomarker to diagnose incipient Alzheimer's disease. The aim of this study was to determine which method of data processing provides highest diagnostic power and to define metrics to further optimize the diagnostic value. fMRI was acquired in 21 healthy subjects, 17 subjects with mild cognitive impairment and 15 patients with Alzheimer's disease (AD) and data evaluated both with volumes of interest (VOI)-based signal time course evaluations and independent component analyses (ICA). The first approach determines the amount of DMN region interconnectivity (as expressed with correlation coefficients); the second method determines the magnitude of DMN coactivation. Apolipoprotein E (ApoE) genotyping was available in 41 of the subjects examined. Diagnostic power (expressed as accuracy) of data of a single DMN region in independent component analyses was 64%, that of a single correlation of time courses between 2 DMN regions was 71%, respectively. With multivariate analyses combining both methods of analysis and data from various regions, accuracy could be increased to 97% (sensitivity 100%, specificity 95%). In nondemented subjects, no significant differences in activity within DMN could be detected comparing ApoE epsilon 4 allele carriers and ApoE epsilon 4 allele noncarriers. However, there were some indications that fMRI might yield useful information given a larger sample. Time course correlation analyses seem to outperform independent component analyses in the identification of patients with Alzheimer's disease. However, multivariate analyses combining both methods of analysis by considering the activity of various parts of the DMN as well as the interconnectivity between these regions are required to achieve optimal and clinically acceptable diagnostic power. (C) 2012 Elsevier Inc. All rights reserved.