Baseline MRI predictors of conversion from MCI to probable AD in the ADNI cohort.
Baseline MRI predictors of conversion from MCI to probable AD in the ADNI cohort.
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DOI：
10.2174/156720509788929273
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发表时间：
2009-08
影响因子：
2.1
通讯作者：
Alzheimer's Disease Neuroimaging Initiative (ADNI)
中科院分区：
文献类型：
--
作者：
Risacher SL;Saykin AJ;West JD;Shen L;Firpi HA;McDonald BC;Alzheimer's Disease Neuroimaging Initiative (ADNI)
阿尔茨海默病神经影像学倡议（ADNI）是一项多中心研究，评估神经影像学在诊断和纵向监测中的作用。遗忘型轻度认知障碍（MCI）通常代表痴呆的前驱形式，每年有10-15%的风险转化为可能的AD。我们分析了来自ADNI队列的693名参与者的基线1.5T MRI扫描，根据基线诊断和一年MCI至可能的AD转换状态分为四组，以确定与MCI和AD相关的神经影像学表型以及即将转换的潜在预测标志物。使用公开提供的基于体素的形态测量（VBM）和自动包裹方法分析MP-RAGE扫描。测量包括全球和海马灰质（GM）密度，海马和杏仁体积，以及内嗅皮质和其他颞叶和顶叶区域的皮质厚度值。与健康对照组（HC，n=206）相比，MCI（n=339）和AD（n=148）中结构MRI变化的总体模式与较小样本中的既往发现相似。MCI转换者（n=62）在达到AD临床标准前一年表现出与AD组非常相似的萎缩性变化模式。最后，MCI转换组和MCI稳定组（n=277）之间MRI指标对比的效应量比较表明，内侧颞叶结构的神经退行性变程度是即将转换的最佳先行MRI标志物，海马体积减小（左>右）最稳健。成像生物标志物的验证很重要，因为它们可以通过识别进展为AD的最高风险个体来帮助丰富疾病修饰剂的临床试验。
The Alzheimer’s Disease Neuroimaging Initiative (ADNI) is a multi-center study assessing neuroimaging in diagnosis and longitudinal monitoring. Amnestic Mild Cognitive Impairment (MCI) often represents a prodromal form of dementia, conferring a 10-15% annual risk of converting to probable AD. We analyzed baseline 1.5T MRI scans in 693 participants from the ADNI cohort divided into four groups by baseline diagnosis and one year MCI to probable AD conversion status to identify neuroimaging phenotypes associated with MCI and AD and potential predictive markers of imminent conversion. MP-RAGE scans were analyzed using publicly available voxel-based morphometry (VBM) and automated parcellation methods. Measures included global and hippocampal grey matter (GM) density, hippocampal and amygdalar volumes, and cortical thickness values from entorhinal cortex and other temporal and parietal lobe regions. The overall pattern of structural MRI changes in MCI (n=339) and AD (n=148) compared to healthy controls (HC, n=206) was similar to prior findings in smaller samples. MCI-Converters (n=62) demonstrated a very similar pattern of atrophic changes to the AD group up to a year before meeting clinical criteria for AD. Finally, a comparison of effect sizes for contrasts between the MCI-Converters and MCI-Stable (n=277) groups on MRI metrics indicated that degree of neurodegeneration of medial temporal structures was the best antecedent MRI marker of imminent conversion, with decreased hippocampal volume (left > right) being the most robust. Validation of imaging biomarkers is important as they can help enrich clinical trials of disease modifying agents by identifying individuals at highest risk for progression to AD.
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