Analysis of the MIRIAD Data Shows Sex Differences in Hippocampal Atrophy Progression
Analysis of the MIRIAD Data Shows Sex Differences in Hippocampal Atrophy Progression
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DOI：
10.3233/jad-150780
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发表时间：
2016-01-01
影响因子：
4
通讯作者：
Bachman, Alvin H.
中科院分区：
文献类型：
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作者：
Ardekani, Babak A.;Convit, Antonio;Bachman, Alvin H.
背景：海马（HC）萎缩是早期阿尔茨海默病（AD）的一个标志。萎缩率可以通过高分辨率结构 MRI 来测量。此前的纵向研究表明，早期 AD 痴呆患者的功能和认知缺陷进展以及脑萎缩率存在性别差异。在独立数据集上证实这些发现非常重要。目的：通过从 AD 最小间隔共振成像 (MIRIAD) 数据库获得的纵向 MRI 扫描，研究可能的 AD 患者和认知正常 (CN) 受试者一年内 HC 萎缩的时间率。方法：我们使用一种新的算法来计算海马指数 MIRIAD 中 43 名轻度至中度可能的 AD 患者和 22 名 CN 受试者在基线和一年随访时的（体积）完整性（HI）。使用支持向量机 (SVM) 分类器评估纵向 HI 测量的诊断能力。结果：AD 组的 HI 显着降低 (p < 10(-20))。此外，AD 组中 HI 降低的年化百分比率显着更高 (p < 10(-13))。在 AD 组中，女性 HI 的年减少量显着大于男性 (p = 0.008)。通过 10 倍交叉验证，AD 和 CN 受试者之间的 SVM 分类准确度估计为 97%。结论：在可能患有 AD 的 MIRIAD 患者中，女性的 HC 萎缩速度明显快于男性。女性是更快陷入 AD 的危险因素。 HI 测量作为 AD 进展的生物标志物和临床试验中的治疗靶标，具有诊断 AD 的潜力。
Background: Hippocampus (HC) atrophy is a hallmark of early Alzheimer's disease (AD). Atrophy rates can be measured by high-resolution structural MRI. Longitudinal studies have previously shown sex differences in the progression of functional and cognitive deficits and rates of brain atrophy in early AD dementia. It is important to corroborate these findings on independent datasets.Objective: To study temporal rates of HC atrophy over a one-year period in probable AD patients and cognitively normal (CN) subjects by longitudinal MRI scans obtained from the Minimal Interval Resonance Imaging in AD (MIRIAD) database.Methods: We used a novel algorithm to compute an index of hippocampal (volumetric) integrity (HI) at baseline and one-year follow-up in 43 mild-moderate probable AD patients and 22 CN subjects in MIRIAD. The diagnostic power of longitudinal HI measurement was assessed using a support vector machines (SVM) classifier.Results: The HI was significantly reduced in the AD group (p < 10(-20)). In addition, the annualized percentage rate of reduction in HI was significantly greater in the AD group (p < 10(-13)). Within the AD group, the annual reduction of HI in women was significantly greater than in men (p = 0.008). The accuracy of SVM classification between AD and CN subjects was estimated to be 97% by 10-fold cross-validation.Conclusion: In the MIRIAD patients with probable AD, the HC atrophies at a significantly faster rate in women as compared to men. Female sex is a risk factor for faster descent into AD. The HI measure has potential for AD diagnosis, as a biomarker of AD progression and a therapeutic target in clinical trials.