Manera Ana L, Dadar Mahsa, Ducharme Simon, Collins D Louis
McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada.
Department of Psychiatry, Douglas Mental Health University Health Centre, McGill University, Montreal, QC H4H 1R3, Canada.
Brain Commun. 2024 Feb 27;6(2):fcae069. doi: 10.1093/braincomms/fcae069. eCollection 2024.
The volume of the lateral ventricles is a reliable and sensitive indicator of brain atrophy and disease progression in behavioural variant frontotemporal dementia. In this study, we validate our previously developed automated tool using ventricular features (known as VentRa) for the classification of behavioural variant frontotemporal dementia versus a mixed cohort of neurodegenerative, vascular and psychiatric disorders from a clinically representative independent dataset. Lateral ventricles were segmented for 1110 subjects-14 behavioural variant frontotemporal dementia, 30 other frontotemporal dementia, 70 Lewy body disease, 898 Alzheimer's disease, 62 vascular brain injury and 36 primary psychiatric disorder from the publicly accessible National Alzheimer's Coordinating Center dataset to assess the performance of VentRa. Using ventricular features to discriminate behavioural variant frontotemporal dementia subjects from primary psychiatric disorders, VentRa achieved an accuracy rate of 84%, a sensitivity rate of 71% and a specificity rate of 89%. VentRa was able to identify behavioural variant frontotemporal dementia from a mixed age-matched cohort (i.e. other frontotemporal dementia, Lewy body disease, Alzheimer's disease, vascular brain injury and primary psychiatric disorders) and to correctly classify other disorders as 'not compatible with behavioral variant frontotemporal dementia' with a specificity rate of 83%. The specificity rates against each of the other individual cohorts were 80% for other frontotemporal dementia, 83% for Lewy body disease, 83% for Alzheimer's disease, 84% for vascular brain injury and 89% for primary psychiatric disorders. VentRa is a robust and generalizable tool with potential usefulness for improving the diagnostic certainty of behavioural variant frontotemporal dementia, particularly for the differential diagnosis with primary psychiatric disorders.
侧脑室体积是行为变异型额颞叶痴呆中脑萎缩和疾病进展的可靠且敏感的指标。在本研究中，我们使用心室特征（称为VentRa）验证了我们之前开发的自动化工具，用于从具有临床代表性的独立数据集中对行为变异型额颞叶痴呆与神经退行性、血管性和精神性疾病的混合队列进行分类。从可公开获取的国家阿尔茨海默病协调中心数据集中，对1110名受试者的侧脑室进行了分割，其中包括14名行为变异型额颞叶痴呆患者、30名其他额颞叶痴呆患者、70名路易体病患者、898名阿尔茨海默病患者、62名血管性脑损伤患者和36名原发性精神障碍患者，以评估VentRa的性能。使用心室特征将行为变异型额颞叶痴呆患者与原发性精神障碍患者区分开来，VentRa的准确率为84%，灵敏度为71%，特异性为89%。VentRa能够从年龄匹配的混合队列（即其他额颞叶痴呆、路易体病、阿尔茨海默病、血管性脑损伤和原发性精神障碍）中识别出行为变异型额颞叶痴呆，并以83%的特异性将其他疾病正确分类为“与行为变异型额颞叶痴呆不相符”。与其他各个单独队列相比，对其他额颞叶痴呆的特异性率为80%，对路易体病为83%，对阿尔茨海默病为83%，对血管性脑损伤为84%，对原发性精神障碍为89%。VentRa是一种强大且可推广的工具，对于提高行为变异型额颞叶痴呆的诊断确定性具有潜在用途，特别是在与原发性精神障碍的鉴别诊断方面。
