FDG-PET and CSF biomarker accuracy in prediction of conversion to different dementias in a large multicentre MCI cohort
Copyright policy )FDG-PET and CSF biomarker accuracy in prediction of conversion to different dementias in a large multicentre MCI cohort
In this multicentre study in clinical settings, we assessed the accuracy of optimized procedures for FDG-PET brain metabolism and CSF classifications in predicting or excluding the conversion to Alzheimer's disease (AD) dementia and non-AD dementias.We included 80 MCI subjects with neurological and neuropsychological assessments, FDG-PET scan and CSF measures at entry, all with clinical follow-up. FDG-PET data were analysed with a validated voxel-based SPM method. Resulting single-subject SPM maps were classified by five imaging experts according to the disease-specific patterns, as "typical-AD", "atypical-AD" (i.e. posterior cortical atrophy, asymmetric logopenic AD variant, frontal-AD variant), "non-AD" (i.e. behavioural variant FTD, corticobasal degeneration, semantic variant FTD; dementia with Lewy bodies) or "negative" patterns. To perform the statistical analyses, the individual patterns were grouped either as "AD dementia vs. non-AD dementia (all diseases)" or as "FTD vs. non-FTD (all diseases)". Aβ42, total and phosphorylated Tau CSF-levels were classified dichotomously, and using the Erlangen Score algorithm. Multivariate logistic models tested the prognostic accuracy of FDG-PET-SPM and CSF dichotomous classifications. Accuracy of Erlangen score and Erlangen Score aided by FDG-PET SPM classification was evaluated.The multivariate logistic model identified FDG-PET "AD" SPM classification (Expβ = 19.35, 95% C.I. 4.8-77.8, p < 0.001) and CSF Aβ42 (Expβ = 6.5, 95% C.I. 1.64-25.43, p < 0.05) as the best predictors of conversion from MCI to AD dementia. The "FTD" SPM pattern significantly predicted conversion to FTD dementias at follow-up (Expβ = 14, 95% C.I. 3.1-63, p < 0.001). Overall, FDG-PET-SPM classification was the most accurate biomarker, able to correctly differentiate either the MCI subjects who converted to AD or FTD dementias, and those who remained stable or reverted to normal cognition (Expβ = 17.9, 95% C.I. 4.55-70.46, p < 0.001).Our results support the relevant role of FDG-PET-SPM classification in predicting progression to different dementia conditions in prodromal MCI phase, and in the exclusion of progression, outperforming CSF biomarkers.
Male, AUC, positron emission tomography, phosphorylated tau, Neuropsychological Tests, Alzheimer's disease dementia; Clinical setting; Erlangen Score; Frontotemporal dementia; Prognosis;, PSP, Aged, 80 and over, Brain, Regular Article, Prognosis, md aMCI, multi-domain amnestic mild cognitive impairment, negative likelihood ratio, MCI, mild cognitive impairment, DLB, Cognitive Dysfunction/cerebrospinal fluid/diagnosis/diagnostic imaging/psychology, Frontotemporal Dementia, Disease Progression, CBD, Prognosi, aMCI, p-tau, phosphorylated tau, Alzheimer Disease/cerebrospinal fluid/diagnosis/diagnostic imaging/psychology, LR+, positive likelihood ratio, 610, CSF, tau Proteins, AUC, area under curve, aMCI, single-domain amnestic mild cognitive impairment, Sensitivity and Specificity, cerebrospinal fluid, total tau, mild cognitive impairment, Alzheimer Disease, dementia with Lewy bodie, EANM, 616, Humans, Biomarkers/cerebrospinal fluid, Cognitive Dysfunction, Aged, AD, EANM, European Association of Nuclear Medicine, Amyloid beta-Peptides/cerebrospinal fluid, bvFTD, PET, CDR, Clinical Dementia Rating, bvFTD, behavioral variant of frontotemporal dementia, Clinical Dementia Rating, Positron-Emission Tomography, single-domain non-amnestic mild cognitive impairment, Neurology. Diseases of the nervous system, Biomarkers, corticobasal degeneration, Radiology, nuclear medicine & imaging, area under curve, FTD, frontotemporal dementia, FDG, fluorodeoxyglucose, Alzheimer's disease dementia, CDR, p-tau, frontotemporal dementia, CSF, cerebrospinal fluid, LR-, negative likelihood ratio, md naMCI, multi-domain non-amnestic mild cognitive impairment, Human health sciences, Phosphorylation, naMCI, naMCI, single-domain non-amnestic mild cognitive impairment, t-tau, total tau, Alzheimer's disease dementia, Clinical setting, Erlangen Score, Frontotemporal dementia, Prognosis, Radiology, Nuclear Medicine and Imaging, Neurology, Neurology (clinical), Cognitive Neuroscience, DLB, dementia with Lewy bodies, FTD, Alzheimer's disease, Middle Aged, PSP, progressive supranuclear palsy, Female, AD, Alzheimer's disease, multi-domain non-amnestic mild cognitive impairment, Frontotemporal dementia, CBD, corticobasal degeneration, t-tau, Alzheimer's disease dementia; Clinical setting; Erlangen Score; Frontotemporal dementia; Prognosis; Radiology, Nuclear Medicine and Imaging; Neurology; Neurology (clinical); Cognitive Neuroscience, FDG, Computer applications to medicine. Medical informatics, R858-859.7, Sciences de la santé humaine, fluorodeoxyglucose, PET, positron emission tomography, Fluorodeoxyglucose F18, Frontotemporal Dementia/cerebrospinal fluid/diagnosis/diagnostic imaging/psychology, European Association of Nuclear Medicine, LR+, LR-, md aMCI, RC346-429, Amyloid beta-Peptides, Radiologie, médecine & imagerie nucléaire, tau Proteins/cerebrospinal fluid, progressive supranuclear palsy, Brain/diagnostic imaging, MCI, behavioral variant of frontotemporal dementia, Clinical setting, md naMCI, single-domain amnestic mild cognitive impairment, multi-domain amnestic mild cognitive impairment, positive likelihood ratio, Erlangen Score
Male, AUC, positron emission tomography, phosphorylated tau, Neuropsychological Tests, Alzheimer's disease dementia; Clinical setting; Erlangen Score; Frontotemporal dementia; Prognosis;, PSP, Aged, 80 and over, Brain, Regular Article, Prognosis, md aMCI, multi-domain amnestic mild cognitive impairment, negative likelihood ratio, MCI, mild cognitive impairment, DLB, Cognitive Dysfunction/cerebrospinal fluid/diagnosis/diagnostic imaging/psychology, Frontotemporal Dementia, Disease Progression, CBD, Prognosi, aMCI, p-tau, phosphorylated tau, Alzheimer Disease/cerebrospinal fluid/diagnosis/diagnostic imaging/psychology, LR+, positive likelihood ratio, 610, CSF, tau Proteins, AUC, area under curve, aMCI, single-domain amnestic mild cognitive impairment, Sensitivity and Specificity, cerebrospinal fluid, total tau, mild cognitive impairment, Alzheimer Disease, dementia with Lewy bodie, EANM, 616, Humans, Biomarkers/cerebrospinal fluid, Cognitive Dysfunction, Aged, AD, EANM, European Association of Nuclear Medicine, Amyloid beta-Peptides/cerebrospinal fluid, bvFTD, PET, CDR, Clinical Dementia Rating, bvFTD, behavioral variant of frontotemporal dementia, Clinical Dementia Rating, Positron-Emission Tomography, single-domain non-amnestic mild cognitive impairment, Neurology. Diseases of the nervous system, Biomarkers, corticobasal degeneration, Radiology, nuclear medicine & imaging, area under curve, FTD, frontotemporal dementia, FDG, fluorodeoxyglucose, Alzheimer's disease dementia, CDR, p-tau, frontotemporal dementia, CSF, cerebrospinal fluid, LR-, negative likelihood ratio, md naMCI, multi-domain non-amnestic mild cognitive impairment, Human health sciences, Phosphorylation, naMCI, naMCI, single-domain non-amnestic mild cognitive impairment, t-tau, total tau, Alzheimer's disease dementia, Clinical setting, Erlangen Score, Frontotemporal dementia, Prognosis, Radiology, Nuclear Medicine and Imaging, Neurology, Neurology (clinical), Cognitive Neuroscience, DLB, dementia with Lewy bodies, FTD, Alzheimer's disease, Middle Aged, PSP, progressive supranuclear palsy, Female, AD, Alzheimer's disease, multi-domain non-amnestic mild cognitive impairment, Frontotemporal dementia, CBD, corticobasal degeneration, t-tau, Alzheimer's disease dementia; Clinical setting; Erlangen Score; Frontotemporal dementia; Prognosis; Radiology, Nuclear Medicine and Imaging; Neurology; Neurology (clinical); Cognitive Neuroscience, FDG, Computer applications to medicine. Medical informatics, R858-859.7, Sciences de la santé humaine, fluorodeoxyglucose, PET, positron emission tomography, Fluorodeoxyglucose F18, Frontotemporal Dementia/cerebrospinal fluid/diagnosis/diagnostic imaging/psychology, European Association of Nuclear Medicine, LR+, LR-, md aMCI, RC346-429, Amyloid beta-Peptides, Radiologie, médecine & imagerie nucléaire, tau Proteins/cerebrospinal fluid, progressive supranuclear palsy, Brain/diagnostic imaging, MCI, behavioral variant of frontotemporal dementia, Clinical setting, md naMCI, single-domain amnestic mild cognitive impairment, multi-domain amnestic mild cognitive impairment, positive likelihood ratio, Erlangen Score
selected citations These citations are derived from selected sources.This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).128 popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.Top 1% influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).Top 10% impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.Top 1%
Citations provided by BIP!Popularity provided by BIP!