An MRI-based strategy for differentiation of frontotemporal dementia and Alzheimer’s disease
Year: 2021
Type: article
Abstract: BACKGROUND: The differential diagnosis of frontotemporal dementia (FTD) and Alzheimer's disease (AD) is difficult due to the overlaps of clinical symptoms. Structural magnetic resonance imaging (sMRI) presents distinct brain atrophy and potentially helps in their differentiation. In this study, we aim at deriving a novel integrated index by leveraging the volumetric measures in brain regions with significant difference between AD and FTD and developing an MRI-based strategy for the differentiation of FTD and AD. METHODS: In this study, the data were acquired from three different databases, including 47 subjects with FTD, 47 subjects with AD, and 47 normal controls in the NACC database; 50 subjects with AD in the ADNI database; and 50 subjects with FTD in the FTLDNI database. The MR images of all subjects were automatically segmented, and the brain atrophy, including the AD resemblance atrophy index (AD-RAI), was quantified using AccuBrain®. A novel MRI index, named the frontotemporal dementia index (FTDI), was derived as the ratio between the weighted sum of the volumetric indexes in "FTD dominant" structures over that obtained from "AD dominant" structures. The weights and the identification of "FTD/AD dominant" structures were acquired from the statistical analysis of NACC data. The differentiation performance of FTDI was validated using independent data from ADNI and FTLDNI databases. RESULTS: AD-RAI is a proven imaging biomarker to identify AD and FTD from NC with significantly higher values (p < 0.001 and AUC = 0.88) as we reported before, while no significant difference was found between AD and FTD (p = 0.647). FTDI showed excellent accuracy in identifying FTD from AD (AUC = 0.90; SEN = 89%, SPE = 75% with threshold value = 1.08). The validation using independent data from ADNI and FTLDNI datasets also confirmed the efficacy of FTDI (AUC = 0.93; SEN = 96%, SPE = 70% with threshold value = 1.08). CONCLUSIONS: Brain atrophy in AD, FTD, and normal elderly shows distinct patterns. In addition to AD-RAI that is designed to detect abnormal brain atrophy in dementia, a novel index specific to FTD is proposed and validated. By combining AD-RAI and FTDI, an MRI-based decision strategy was further proposed as a promising solution for the differential diagnosis of AD and FTD in clinical practice.
Source: Alzheimer s Research & Therapy
Authors: Qun Yu, the Frontotemporal Lobar Degeneration Neuroimaging Initiative, Yingren Mai, Yuting Ruan, Yishan Luo, Lei Zhao, Wenli Fang, Zhiyu Cao, Yi Li, Wang Liao, Songhua Xiao, Vincent C. T. Mok, Lin Shi, Jun Liu
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,490
Funders: U.S. Department of Defense, Alzheimer's Association, Bristol-Myers Squibb, Eli Lilly and Company, Biogen, F. Hoffmann-La Roche, BioClinica, National Natural Science Foundation of China, Natural Science Foundation of Guangdong Province, Eisai, National Institutes of Health, Genentech, National Institute on Aging, National Institute of Biomedical Imaging and Bioengineering
Awards: G1012222616, G1017046091, G104586243, G1053905225, G1075639496, G1104192986, G1106781614, G113062254, G1171648585, G1173778324, G117713310, G1195298871, G1228824270, G1263262031, Michigan Alzheimer's Disease Core Center, UC Davis Alzheimer's Disease Core Center, Indiana Alzheimer Disease Center, G1369195717, G1375833519, G1492531059, G1554142629, G1602633198, G1614502467, G1650819308, G1663213784, G1711016037, G1859882300, G1906177454, Alzheimer's Disease Neuroimaging Initiative, G2075747288, G2105457377, G2189010064, G219693323, G2334192300, G2340207221, G234895681, G2468911699, G2515091901, G2522063444, Neurobiology of Alzheimer's Disease and Aging, G2640555407, G2769554943, G282710236, G2929235049, G2984989008, G3026342146, G3066742295, G3130427885, G3131374986, G3146424788, G3218891203, G3308348438, G3335858628, G3359100610, G3439557519, G348743638, G3553156159, G3594582125, G36881302, G3710456697, G3818147302, G384347443, G3868925638, G3870774570, G3876327265, G3919444319, G3946457848, G3966393351, G40706755, G4076092645, G4082276054, G4103239427, G4119534169, G43180419, G4318823550, Cleveland Alzheimer's Disease Research Center, G4417220376, G4475667458, G4684857399, G469773307, G470063782, G4800177743, G4874008555, G4968636904, G5207404921, EFFECTS OF TRAUMATIC BRAIN INJURY (TBI) AND POST TRAUMATIC STRESS DISORDER (PTSD) ON ALZHEIMER'S DISEASE (AD) IN VETERANS USING IMAGING AND BIOMARKERS IN THE AD NEUROIMAGING INITIATIVE (ADNI)", G5389965057, G556672640, G5654639750, G5850682332, G5971171967, G5977822913, G603598372, G6210868510, G6371410416, G639043084, G6412110892, G6445626367, G6492025387, University of Kansas Alzheimer's Disease Core Centers, G6750444795, G6792506723, G6876577119, G6899163935, The Frontotemporal Lobar Degeneration Neuroimaging Initiative, G6948409098, Alzheimer Disease Research Center, G7042289108, Arizona Alzheimer's Disease Core Center, Johns Hopkins Alzheimer's Disease Research Center, G7176475171, G7409097460, G7576515556, Boston University Alzheimer's Disease Center, G76412088, G764699806, G781725486, Alzheimer's Disease Core Center, G8018240826, University of Florida - Mt. Sinai Medical Center AD Research Center, G8151151163, G816726602, G8228018387, G828200374, G8620018032, G873702183, G8895907669, G8957659042, G9000000175, G9000003466, G9000004804, G9000008846, G9000010277, G9000013408, G9000017672, G9000018678, G9000021351, G9000024008, G9000025891, G9000030076, G9000030722, G9000031515, G9000033698, G9000035486, G9000036492, G9000039018, G9000043956, G9000044543, G9000046703, G9000058880, G9000060917, G9000064269, G9000070217, G9000074849, G9000074900, G9000104082, G9000108235, G9000113984, G9000114108, G9000119544, G9000122335, G9000126115, G9000131182, G9000132673, G9000145746, G9000147311, G9000151373, G9000167101, G9000167523, G9000208313, G9000212151, G9000218452, G9000218858, G9000227227, G9000227779, G9000252716, G9000274623, G9000307348, G9000332211, G9000354213, UCSD Shiley-Marcos Alzheimer's Disease Research Center P30, G920654007, G945380068
OpenAlex ID: W3120639558