Multiparametric MRI to distinguish early onset Alzheimer's disease and behavioural variant of frontotemporal dementia.
Multiparametric MRI to distinguish early onset Alzheimer's disease and behavioural variant of frontotemporal dementia.
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DOI：
10.1016/j.nicl.2017.05.018
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Filippi M
中科院分区：
文献类型：
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作者：
Canu E;Agosta F;Mandic-Stojmenovic G;Stojković T;Stefanova E;Inuggi A;Imperiale F;Copetti M;Kostic VS;Filippi M
这项前瞻性研究探讨了结合结构[皮质厚度和白色物质（WM）微观结构]和静息状态功能MRI的方法是否有助于区分62例早发性阿尔茨海默病（EOAD）和27例行为变异型额颞叶痴呆（bvFTD）患者。随机森林和受试者操作特征曲线分析评估了MRI对两种临床综合征进行分类的能力。相对于对照组，所有患者均表现出大脑改变的分布模式。与bvFTD相比，EOAD患者显示双侧下顶叶皮质变薄和默认模式网络功能连接降低。与EOAD相比，bvFTD患者显示双侧眶额和颞叶皮质变薄，以及胼胝体、双侧钩束和左侧上级纵束的WM损伤。随机森林分析显示，左下顶叶皮质厚度（准确度0.78，特异度0.76，灵敏度0.83）和右钩束WM完整性（准确度0.81，特异度0.96，灵敏度0.43）是临床诊断的最佳预测因素。皮质厚度和DT MRI测量的组合能够区分EOAD和bvFTD患者，准确度为0.82，特异性为0.76，灵敏度为0.96。MRI模型的诊断能力在具有基于生物标志物的临床诊断的患者的子样本中得到证实。多参数MRI可用于识别EOAD和bvFTD特异性脑改变。重度皮质受累提示EOAD，而明显WM损伤提示bvFTD。多模式MRI区分体内EOAD和bvFTD患者EOAD和bvFTD显示脑结构改变的分布模式重度皮质受累提示EOAD相对于bvFTD显著WM损伤提示bvFTD相对于EOAD
This prospective study explored whether an approach combining structural [cortical thickness and white matter (WM) microstructure] and resting state functional MRI can aid differentiation between 62 early onset Alzheimer's disease (EOAD) and 27 behavioural variant of frontotemporal dementia (bvFTD) patients. Random forest and receiver operator characteristic curve analyses assessed the ability of MRI in classifying the two clinical syndromes. All patients showed a distributed pattern of brain alterations relative to controls. Compared to bvFTD, EOAD patients showed bilateral inferior parietal cortical thinning and decreased default mode network functional connectivity. Compared to EOAD, bvFTD patients showed bilateral orbitofrontal and temporal cortical thinning, and WM damage of the corpus callosum, bilateral uncinate fasciculus, and left superior longitudinal fasciculus. Random forest analysis revealed that left inferior parietal cortical thickness (accuracy 0.78, specificity 0.76, sensitivity 0.83) and WM integrity of the right uncinate fasciculus (accuracy 0.81, specificity 0.96, sensitivity 0.43) were the best predictors of clinical diagnosis. The combination of cortical thickness and DT MRI measures was able to distinguish patients with EOAD and bvFTD with accuracy 0.82, specificity 0.76, and sensitivity 0.96. The diagnostic ability of MRI models was confirmed in a subsample of patients with biomarker-based clinical diagnosis. Multiparametric MRI is useful to identify brain alterations which are specific to EOAD and bvFTD. A severe cortical involvement is suggestive of EOAD, while a prominent WM damage is indicative of bvFTD. Multimodal MRI distinguishes in vivo EOAD and bvFTD patients EOAD and bvFTD show a distributed pattern of structural brain alterations A severe cortical involvement is suggestive of EOAD relative to bvFTD A prominent WM damage is indicative of bvFTD relative to EOAD