Is Long-Term Prognosis of Frontotemporal Lobar Degeneration Predictable by Neuroimaging? Evidence from a Single-Subject Functional Brain Study
Is Long-Term Prognosis of Frontotemporal Lobar Degeneration Predictable by Neuroimaging? Evidence from a Single-Subject Functional Brain Study
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DOI：
10.3233/jad-2012-112078
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发表时间：
2012-01-01
影响因子：
4
通讯作者：
Padovani, Alessandro
中科院分区：
文献类型：
--
作者：
Borroni, Barbara;Grassi, Mario;Padovani, Alessandro
额颞叶变性(FTLD)的存活率预测只是猜测。本研究的目的是评估SPECT扫描是否有助于预测FTLD患者的长期生存预后。纳入了125名FTLD患者，他们在登记时接受了脑SPECT扫描，并进一步随访了至少一年。在每个受试者中，绘制了覆盖额颞区和顶区的兴趣量(VOI)。将主成分分析(PCA)应用于VOIS，并用COX回归模型找出影响生存的最佳因素。选择了两个模式的主成分分析方案，解释了70%以上的方差，并识别了“正面”PC1和“临时”PC2成分。单因素模型的HR=2.0 6，95%CI=1.2 3~3.4 4，p=0.006；多因素模型的HR=1.85，95%CI=1.0 4~3.2 8，p=0.0 3。特别是，右侧眶前叶皮质在PC1显示出较高的负荷；该区域的评分越差，生存时间就越短。我们认为，SPECT成像不仅是诊断评估的有用工具，而且可能是FTLD疾病结局的一个容易和易用的标志。考虑结构神经成像的进一步研究是有必要的。
Prediction of survival in frontotemporal lobar degeneration (FTLD) is guesswork. The aim of the present study was to evaluate whether SPECT scan may be useful to predict prognosis of long term survival in FTLD patients. A cohort of 125 patients with FTLD who underwent brain SPECT scan at the time of enrollment and who were further followed up for at least one year were considered. In each subject, volume of interests (VOIs) covering frontotemporal and parietal regions, bilaterally, were drawn. Principal component analysis (PCA) was applied on VOIs, and a Cox regression model was carried out to find out best predictors of survival. A two-pattern PCA solution was chosen, explaining more than 70% of variance, and "frontal" PC1 and "temporal" PC2 components were identified. The frontal PC1 was associated with higher rate of faster progression (HR = 2.06, 95% CI = 1.23-3.44, p = 0.006 for univariate model, and HR = 1.85, 95% CI = 1.04-3.28, p = 0.03 for multivariate model). In particular, right orbitofrontal cortex showed the higher loadings in PC1; the worse the scores of this region the shorter the survival was reported. We suggest that SPECT imaging, beyond a helpful tool in diagnostic assessment, may be an easily and accessible marker of disease outcome in FTLD. Further studies considering structural neuroimaging are warranted.