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自动脑 MRI 容积测量可区分阿尔茨海默病的早期阶段与正常衰老。

Automated Brain MRI Volumetry Differentiates Early Stages of Alzheimer's Disease From Normal Aging.

机构信息

1 Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China.

2 Department of Neurology, Mudanjiang Medical University Affiliated HongQi Hospital, Mudanjiang, China.

出版信息

J Geriatr Psychiatry Neurol. 2019 Nov;32(6):354-364. doi: 10.1177/0891988719862637.

Abstract

As an enrichment strategy supplemented by the diagnostic framework of subjective cognitive decline (SCD), SCD identifies features that may increase the likelihood of including future-Alzheimer's disease (AD) patients. This study aimed to identify the shared and distinct atrophy patterns between patients specified by SCD and amnestic mild cognitive impairment (aMCI, a prodromal stage of AD) and to investigate the extent that automated brain magnetic resonance imaging (MRI) volumetry can differentiate patients with SCD from normal control (NC) participants and patients with aMCI. We acquired structural MRI brain scans from 44 patients with aMCI, 40 patients with SCD (who met the major criteria of SCD ), and 48 NC participants. Automatic brain segmentation was performed to quantify the volumetric measures of cognitive-relevant areas. These volumetric measures were compared across the 3 groups with analysis of variance. In addition, we performed support vector machine analyses using volumetric measures of single regions or multiple regions to further evaluate the sensitivity of automated brain volumetry in differentiating a specific group from another. The atrophy patterns in patients with aMCI and SCD were similar. Using the regional volumetric measures, we achieved high performance in differentiating aMCI and SCD from NCs (average classification accuracy [ACC] > 90%). However, the performance was not ideal when differentiating aMCI from SCD (ACC < 63%). In conclusion, patients with SCD specified by SCD presented similar atrophy patterns as patients with aMCI, which was distinguishable from NC participants. Future studies should aim to associate the atrophy patterns of SCD with possible conversion to aMCI or AD in a longitudinal design.

摘要

作为对主观认知下降(SCD)诊断框架的补充的富集策略,SCD 确定了可能增加包括未来阿尔茨海默病(AD)患者的可能性的特征。本研究旨在确定 SCD 患者与遗忘型轻度认知障碍(AD 的前驱阶段 aMCI)患者之间共享和独特的萎缩模式,并研究自动脑磁共振成像(MRI)容积测量在多大程度上可以区分 SCD 患者与正常对照组(NC)参与者和 aMCI 患者。我们从 44 名 aMCI 患者、40 名 SCD 患者(符合 SCD 的主要标准)和 48 名 NC 参与者中获得了结构 MRI 脑扫描。进行了自动脑分割以量化认知相关区域的容积测量值。使用方差分析比较了 3 组之间的这些容积测量值。此外,我们使用单区域或多个区域的容积测量值进行了支持向量机分析,以进一步评估自动脑容积测量在区分特定组与其他组的敏感性。aMCI 和 SCD 患者的萎缩模式相似。使用区域容积测量值,我们在区分 aMCI 和 SCD 与 NCs 方面取得了很高的性能(平均分类准确性[ACC]>90%)。然而,当区分 aMCI 与 SCD 时,性能并不理想(ACC<63%)。总之,SCD 患者的萎缩模式与 SCD 向 aMCI 或 AD 的可能转化相关,这在纵向设计中应进一步研究。

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