Guo Hui, Song Xiaowei, Schmidt Matthias H, Vandorpe Robert, Yang Zhan, LeBlanc Emily, Zhang Jing, Beyea Steven, Zhang Yunting, Rockwood Kenneth
Neuroimaging Research Laboratory, Biomedical Translational Imaging Centre, QEII-IWK Health Sciences Centre (the former National Research Council Canada's Institute for Biodiagnostics - Atlantic), Halifax, NS, Canada Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China.
Neuroimaging Research Laboratory, Biomedical Translational Imaging Centre, QEII-IWK Health Sciences Centre (the former National Research Council Canada's Institute for Biodiagnostics - Atlantic), Halifax, NS, Canada Department of Medicine, Dalhousie University, Halifax, NS, Canada.
J Alzheimers Dis. 2014;42(2):691-703. doi: 10.3233/JAD-140333.
The Brain Atrophy and Lesion Index (BALI), a semi-quantitative rating scale, has been developed to evaluate whole brain structural changes in aging and Alzheimer's disease (AD).
This study describes a standard procedure to score the BALI and train new raters for reliable BALI evaluation following this procedure.
Structural MRI of subjects in the Alzheimer's Disease Neuroimaging Initiative dataset who had 3.0T, T1, and T2 weighted MRI scans at baseline and at 6, 12, and 24 month follow-ups were retrieved (n = 122, including 24 AD, 51 mild cognitive impairment patients, and 47 healthy control subjects). Images were evaluated by four raters following training with a step-by-step BALI process. Seven domains of structural brain changes were evaluated, and a total score was calculated as the sum of the sub-scores.
New raters achieved >90% accuracy after two weeks of training. Reliability was shown in both intra-rater correlation coefficients (ICC ≥ 0.92, p < 0.001) and inter-rater correlation coefficients (ICC ≥0.88, p < 0.001). Mean BALI total scores differed by diagnosis (F ≥ 2.69, p ≤ 0.049) and increased consistently over two years.
The BALI can be introduced using a standard procedure that allows new users to achieve highly reliable evaluation of structural brain changes. This can advance its potential as a robust method for assessing global brain health in aging, AD, and mild cognitive impairment.
脑萎缩与病变指数（BALI）是一种半定量评分量表，已被开发用于评估衰老和阿尔茨海默病（AD）中的全脑结构变化。
本研究描述了一种对BALI进行评分的标准程序，并培训新的评分者按照该程序进行可靠的BALI评估。
检索阿尔茨海默病神经影像倡议数据集中在基线以及随访6个月、12个月和24个月时进行了3.0T、T1加权和T2加权MRI扫描的受试者的结构MRI（n = 122，包括24例AD患者、51例轻度认知障碍患者和47例健康对照受试者）。在按照BALI的逐步流程进行培训后，由四名评分者对图像进行评估。评估了脑结构变化的七个领域，并计算总分作为各子分数之和。
经过两周的培训，新评分者的准确率达到了90%以上。评分者内相关系数（ICC≥0.92，p<0.001）和评分者间相关系数（ICC≥0.88，p<0.001）均显示出可靠性。BALI总分均值因诊断而异（F≥2.69，p≤0.049），且在两年内持续增加。
可以采用一种标准程序引入BALI，使新用户能够对脑结构变化进行高度可靠的评估。这可以提升其作为评估衰老、AD和轻度认知障碍中全球脑健康的强大方法的潜力。
