淀粉样蛋白生物标志物作为从轻度认知障碍到阿尔茨海默病痴呆转化的预测因子：方法比较。
Amyloid biomarkers as predictors of conversion from mild cognitive impairment to Alzheimer's dementia: a comparison of methods.
机构信息
Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
出版信息
Alzheimers Res Ther. 2020 Nov 19;12(1):155. doi: 10.1186/s13195-020-00721-3.
BACKGROUND
Amyloid-β (Aβ) PET is an established predictor of conversion from mild cognitive impairment (MCI) to Alzheimer's dementia (AD). We compared three PET (including an approach based on voxel-wise Cox regression) and one cerebrospinal fluid (CSF) outcome measures in their predictive power.
METHODS
Datasets were retrieved from the ADNI database. In a training dataset (N = 159), voxel-wise Cox regression and principal component analyses were used to identify conversion-related regions (Cox-VOI and AD conversion-related pattern (ADCRP), respectively). In a test dataset (N = 129), the predictive value of mean normalized F-florbetapir uptake (SUVR) in AD-typical brain regions (composite SUVR) or the Cox-VOI and the pattern expression score (PES) of ADCRP and CSF Aβ/Aβ as predictors were compared by Cox models (corrected for age and sex).
RESULTS
All four Aβ measures were significant predictors (p < 0.001). Prediction accuracies (Harrell's c) showed step-wise significant increases from Cox-SUVR (c = 0.71; HR = 1.84 per Z-score increase), composite SUVR (c = 0.73; HR = 2.18), CSF Aβ/Aβ (c = 0.75; HR = 3.89) to PES (c = 0.77; HR = 2.71).
CONCLUSION
The PES of ADCRP is the most predictive Aβ PET outcome measure, comparable to CSF Aβ/Aβ, with a slight but statistically significant advantage.
背景
淀粉样蛋白-β（Aβ）PET 是从轻度认知障碍（MCI）向阿尔茨海默病（AD）转化的既定预测因子。我们比较了三种 PET（包括基于体素 Cox 回归的方法）和一种脑脊液（CSF）结果测量在其预测能力方面的表现。
方法
从 ADNI 数据库中检索数据集。在训练数据集（N=159）中，使用体素 Cox 回归和主成分分析来识别与转化相关的区域（分别为 Cox-VOI 和 AD 转化相关模式（ADCRP））。在测试数据集（N=129）中，使用 Cox 模型（校正年龄和性别）比较 AD 典型脑区平均归一化 F-氟比他滨摄取（SUVR）（复合 SUVR）或 Cox-VOI 和 ADCRP 的模式表达评分（PES）以及 CSF Aβ/Aβ 作为预测因子的预测价值。
结果
所有四种 Aβ 测量值均为显著预测因子（p<0.001）。预测准确率（Harrell 的 c）显示出逐步显著增加，从 Cox-SUVR（c=0.71；每增加一个 Z 分数 HR=1.84）、复合 SUVR（c=0.73；HR=2.18）、CSF Aβ/Aβ（c=0.75；HR=3.89）到 PES（c=0.77；HR=2.71）。
结论
ADCRP 的 PES 是最具预测性的 Aβ PET 结果测量值，与 CSF Aβ/Aβ 相当，略有但具有统计学意义的优势。
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