Giannakopoulos Panteleimon, Montandon Marie-Louise, Rodriguez Cristelle, Haller Sven, Garibotto Valentina, Herrmann François R
Department of Psychiatry, University of Geneva, Geneva, Switzerland.
Medical Direction, Geneva University Hospitals, Geneva, Switzerland.
Front Aging Neurosci. 2021 Jul 12;13:664224. doi: 10.3389/fnagi.2021.664224. eCollection 2021.
Quantitative imaging processing tools have been proposed to improve clinic-radiological correlations but their added value at the initial stages of cognitive decline is still a matter of debate. We performed a longitudinal study in 90 community-dwelling elders with three neuropsychological assessments during a 4.5 year follow-up period, and visual assessment of medial temporal atrophy (MTA), white matter hyperintensities, cortical microbleeds (CMB) as well as amyloid positivity, and presence of abnormal FDG-PET patterns. Quantitative imaging data concerned ROI analysis of MRI volume, amyloid burden, and FDG-PET metabolism in several AD-signature areas. Multiple regression models, likelihood-ratio tests, and areas under the receiver operating characteristic curve (AUC) were used to compare quantitative imaging markers to visual inspection. The presence of more or equal to four CMB at inclusion and slight atrophy of the right MTL at follow-up were the only parameters to be independently related to the worst cognitive score explaining 6% of its variance. This percentage increased to 24.5% when the ROI-defined volume loss in the posterior cingulate cortex, baseline hippocampus volume, and MTL metabolism were also considered. When binary classification of cognition was made, the area under the ROC curve increased from 0.69 for the qualitative to 0.79 for the mixed imaging model. Our data reveal that the inclusion of quantitative imaging data significantly increases the prediction of cognitive changes in elderly controls compared to the single consideration of visual inspection.
已经提出了定量成像处理工具来改善临床与放射学的相关性，但其在认知衰退初始阶段的附加价值仍存在争议。我们对90名社区居住的老年人进行了一项纵向研究，在4.5年的随访期内进行了三次神经心理学评估，并对内侧颞叶萎缩（MTA）、白质高信号、皮质微出血（CMB）以及淀粉样蛋白阳性和异常氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）模式进行了视觉评估。定量成像数据涉及几个阿尔茨海默病特征区域的MRI体积、淀粉样蛋白负荷和FDG-PET代谢的感兴趣区域（ROI）分析。使用多元回归模型、似然比检验和受试者操作特征曲线（AUC）下的面积来比较定量成像标记与视觉检查。纳入时存在四个或更多的CMB以及随访时右侧内侧颞叶（MTL）轻度萎缩是仅有的与最差认知评分独立相关的参数，可解释其6%的方差。当还考虑扣带回后部ROI定义的体积损失、基线海马体积和MTL代谢时，这一百分比增加到24.5%。当进行认知的二元分类时，ROC曲线下的面积从定性的0.69增加到混合成像模型的0.79。我们的数据表明，与仅考虑视觉检查相比，纳入定量成像数据显著提高了对老年对照认知变化的预测。
