Loreto Flavia, Verdi Serena, Kia Seyed Mostafa, Duvnjak Aleksandar, Hakeem Haneen, Fitzgerald Anna, Patel Neva, Lilja Johan, Win Zarni, Perry Richard, Marquand Andre F, Cole James H, Malhotra Paresh
Department of Brain Sciences Faculty of Medicine Imperial College London London UK.
Centre for Medical Image Computing Medical Physics and Biomedical Engineering University College London London UK.
Alzheimers Dement (Amst). 2024 Mar 13;16(1):e12559. doi: 10.1002/dad2.12559. eCollection 2024 Jan-Mar.
Overlooking the heterogeneity in Alzheimer's disease (AD) may lead to diagnostic delays and failures. Neuroanatomical normative modeling captures individual brain variation and may inform our understanding of individual differences in AD-related atrophy.
We applied neuroanatomical normative modeling to magnetic resonance imaging from a real-world clinical cohort with confirmed AD ( = 86). Regional cortical thickness was compared to a healthy reference cohort ( = 33,072) and the number of outlying regions was summed (total outlier count) and mapped at individual- and group-levels.
The superior temporal sulcus contained the highest proportion of outliers (60%). Elsewhere, overlap between patient atrophy patterns was low. Mean total outlier count was higher in patients who were non-amnestic, at more advanced disease stages, and without depressive symptoms. Amyloid burden was negatively associated with outlier count.
Brain atrophy in AD is highly heterogeneous and neuroanatomical normative modeling can be used to explore anatomo-clinical correlations in individual patients.
忽视阿尔茨海默病（AD）的异质性可能导致诊断延迟和失败。神经解剖学规范建模可捕捉个体大脑变异，并有助于我们理解AD相关萎缩的个体差异。
我们将神经解剖学规范建模应用于来自一个确诊为AD的真实世界临床队列（n = 86）的磁共振成像。将区域皮质厚度与一个健康对照队列（n = 33,072）进行比较，并汇总异常区域的数量（总异常计数），并在个体和组水平上进行映射。
颞上沟的异常值比例最高（60%）。在其他地方，患者萎缩模式之间的重叠程度较低。非遗忘型、疾病阶段较晚期且无抑郁症状的患者平均总异常计数较高。淀粉样蛋白负荷与异常计数呈负相关。
AD中的脑萎缩具有高度异质性，神经解剖学规范建模可用于探索个体患者的解剖-临床相关性。
