Deformation based morphometry study of longitudinal MRI changes in behavioral variant frontotemporal dementia
Deformation based morphometry study of longitudinal MRI changes in behavioral variant frontotemporal dementia
复制标题
DOI：
10.1016/j.nicl.2019.102079
复制
发表时间：
2019-01-01
影响因子：
4.2
通讯作者：
Ducharme, Simon
中科院分区：
文献类型：
--
作者：
Manera, Ana L.;Dadar, Mahsa;Ducharme, Simon
目的：客观量化脑容量损失如何有助于额颞叶痴呆行为变异型（bvFTD）的临床诊断和临床试验设计。方法：我们应用基于变形的形态测量分析和稳健配准，以精确量化bvFTD患者与认知正常对照（CNC）相比的萎缩程度和模式，评估一年随访中萎缩的进展，并产生临床试验样本量估计值，以检测对变化最敏感的结构的差异。这项研究包括203名受试者- 70 bvFTD和133 CNCs -共482个时间点，从额颞叶变性Neuroimaging Initiative.Results：变形为基础的形态测定（DBM）显示显着萎缩的额叶，颞叶，内侧和前颞区双侧bvFTD受试者相比，控制与突出的皮质下受累。我们提供每年区域变化的详细信息。在横断面分析和一年的随访期间，心室扩张是bvFTD从控制和疾病进展的一个敏感的标志物的最突出的区别：结论：心室扩张的自动测量是一个敏感和可靠的标志物的疾病进展bvFTD用于潜在的疾病修饰药物的临床试验，以及可能在临床实践中实施。使用DBM测量的心室扩张为临床试验设计提供了最低的已发表估计样本量，以检测1年和2年内的显著差异。
Objective: To objectively quantify how cerebral volume loss could assist with clinical diagnosis and clinical trial design in the behavioural variant of frontotemporal dementia (bvFTD).Methods: We applied deformation-based morphometric analyses with robust registration to precisely quantify the magnitude and pattern of atrophy in patients with bvFTD as compared to cognitively normal controls (CNCs), to assess the progression of atrophy over one year follow up and to generate clinical trial sample size estimates to detect differences for the structures most sensitive to change. This study included 203 subjects - 70 bvFTD and 133 CNCs - with a total of 482 timepoints from the Frontotemporal Lobar Degeneration Neuroimaging Initiative.Results: Deformation based morphometry (DBM) revealed significant atrophy in the frontal lobes, insula, medial and anterior temporal regions bilaterally in bvFTD subjects compared to controls with outstanding subcortical involvement. We provide detailed information on regional changes per year. In both cross-sectional analysis and over a one-year follow-up period, ventricle expansion was the most prominent differentiator of bvFTD from controls and a sensitive marker of disease progression.Conclusions: Automated measurement of ventricular expansion is a sensitive and reliable marker of disease progression in bvFTD to be used in clinical trials for potential disease modifying drugs, as well as possibly to implement in clinical practice. Ventricular expansion measured with DBM provides the lowest published estimated sample size for clinical trial design to detect significant differences over one and two years.