Twelve-month metabolic declines in probable Alzheimer's disease and amnestic mild cognitive impairment assessed using an empirically pre-defined statistical region-of-interest: findings from the Alzheimer's Disease Neuroimaging Initiative.
Twelve-month metabolic declines in probable Alzheimer's disease and amnestic mild cognitive impairment assessed using an empirically pre-defined statistical region-of-interest: findings from the Alzheimer's Disease Neuroimaging Initiative.
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DOI：
10.1016/j.neuroimage.2010.02.064
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发表时间：
2010-06
期刊：
影响因子：
5.7
通讯作者：
Reiman, Eric M.
中科院分区：
文献类型：
--
作者：
Chen, Kewei;Langbaum, Jessica B. S.;Fleisher, Adam S.;Ayutyanont, Napatkamon;Reschke, Cole;Lee, Wendy;Liu, Xiaofen;Bandy, Dan;Alexander, Gene E.;Thompson, Paul M.;Foster, Norman L.;Harvey, Danielle J.;de Leon, Mony J.;Koeppe, Robert A.;Jagust, William J.;Weiner, Michael W.;Reiman, Eric M.
阿尔茨海默病（AD）的特征在于葡萄糖脑代谢率（CMRgl）的氟脱氧葡萄糖正电子发射断层扫描（FDG PET）测量的特异性和进行性降低，其中一些可能先于症状发作。在这份报告中，我们描述了12个月的CMRgl下降69可能AD患者，154遗忘型轻度认知障碍（MCI）患者，和79认知正常对照（NC）从AD神经影像学倡议（ADNI）使用统计参数映射（SPM）。我们介绍了使用经验预定义的统计感兴趣区域（sROI）来表征CMRgl下降，具有最佳功效和多重比较的自由，并且我们估计了在多中心随机临床试验（RCT）中表征AD减缓治疗效果所需的患者数量。AD和MCI组各自在后扣带回、内侧和外侧顶叶、内侧和外侧颞叶、额叶和枕叶皮质中双侧具有显著的12个月CMRgl下降，其显著大于NC组中的那些并且与临床下降的测量相关。使用基于基线和随访图像的训练集定义的sROI来评估来自每个患者组的独立测试集中的CMRgl下降，我们估计每个治疗组需要66名AD患者或217名MCI患者在12个月的多中心RCT中检测25%的AD减缓治疗效果，其中功效为80%，双尾α =0.05，大约是使用临床终点研究MCI患者所需患者数量的十分之一。我们的研究结果支持在AD减缓治疗的RCT中使用FDG PET、脑标测算法和经验性预先定义的sROI。
Alzheimer's disease (AD) is characterized by specific and progressive reductions in fluorodeoxyglucose positron emission tomography (FDG PET) measurements of the cerebral metabolic rate for glucose (CMRgl), some of which may precede the onset of symptoms. In this report, we describe twelve-month CMRgl declines in 69 probable AD patients, 154 amnestic mild cognitive impairment (MCI) patients, and 79 cognitively normal controls (NCs) from the AD Neuroimaging Initiative (ADNI) using statistical parametric mapping (SPM). We introduce the use of an empirically predefined statistical region-of-interest (sROI) to characterize CMRgl declines with optimal power and freedom from multiple comparisons, and we estimate the number of patients needed to characterize AD-slowing treatment effects in multi-center randomized clinical trials (RCTs). The AD and MCI groups each had significant twelve-month CMRgl declines bilaterally in posterior cingulate, medial and lateral parietal, medial and lateral temporal, frontal and occipital cortex, which were significantly greater than those in the NC group and correlated with measures of clinical decline. Using sROIs defined based on training sets of baseline and follow-up images to assess CMRgl declines in independent test sets from each patient group, we estimate the need for 66 AD patients or 217 MCI patients per treatment group to detect a 25% AD-slowing treatment effect in a twelve-month, multi-center RCT with 80% power and two-tailed alpha=0.05, roughly one-tenth the number of the patients needed to study MCI patients using clinical endpoints. Our findings support the use of FDG PET, brain-mapping algorithms and empirically pre-defined sROIs in RCTs of AD-slowing treatments.
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影响因子：
17.7
作者：
Alexander, GE;Chen, K;Reiman, EM
通讯作者：
Reiman, EM
影响因子：
5.7
作者：
Herholz, K;Salmon, E;Heiss, WD
通讯作者：
Heiss, WD
影响因子：
9.9
作者：
Li, G.;Sokal, I.;Montine, T. J.
通讯作者：
Montine, T. J.
影响因子：
5.7
作者：
Langbaum JB;Chen K;Lee W;Reschke C;Bandy D;Fleisher AS;Alexander GE;Foster NL;Weiner MW;Koeppe RA;Jagust WJ;Reiman EM;Alzheimer's Disease Neuroimaging Initiative
通讯作者：
Alzheimer's Disease Neuroimaging Initiative
影响因子：
11.2
作者：
Klunk, WE;Engler, H;Långström, B
通讯作者：
Långström, B