通过全脑白质模式评估老年人的认知障碍和残疾。
Assessing cognitive impairment and disability in older adults through the lens of whole brain white matter patterns.
机构信息
Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
Cognitive Science Research Group, Korea Brain Research Institute, Daegu, Republic of Korea.
出版信息
Alzheimers Dement. 2024 Sep;20(9):6032-6044. doi: 10.1002/alz.14094. Epub 2024 Jul 12.
INTRODUCTION
This study aimed to explore the potential of whole brain white matter patterns as novel neuroimaging biomarkers for assessing cognitive impairment and disability in older adults.
METHODS
We conducted an in-depth analysis of magnetic resonance imaging (MRI) and amyloid positron emission tomography (PET) scans in 454 participants, focusing on white matter patterns and white matter inter-subject variability (WM-ISV).
RESULTS
The white matter pattern ensemble model, combining MRI and amyloid PET, demonstrated a significantly higher classification performance for cognitive impairment and disability. Participants with Alzheimer's disease (AD) exhibited higher WM-ISV than participants with subjective cognitive decline, mild cognitive impairment, and vascular dementia. Furthermore, WM-ISV correlated significantly with blood-based biomarkers (such as glial fibrillary acidic protein and phosphorylated tau-217 [p-tau217]), and cognitive function and disability scores.
DISCUSSION
Our results suggest that white matter pattern analysis has significant potential as an adjunct neuroimaging biomarker for clinical decision-making and determining cognitive impairment and disability.
HIGHLIGHTS
The ensemble model combined both magnetic resonance imaging (MRI) and amyloid positron emission tomography (PET) and demonstrated a significantly higher classification performance for cognitive impairment and disability. Alzheimer's disease (AD) revealed a notably higher heterogeneity compared to that in subjective cognitive decline, mild cognitive impairment, or vascular dementia. White matter inter-subject variability (WM-ISV) was significantly correlated with blood-based biomarkers (glial fibrillary acidic protein and phosphorylated tau-217 [p-tau217]) and with the polygenic risk score for AD. White matter pattern analysis has significant potential as an adjunct neuroimaging biomarker for clinical decision-making processes and determining cognitive impairment and disability.
简介
本研究旨在探索全脑白质模式作为评估老年认知障碍和残疾的新型神经影像学生物标志物的潜力。
方法
我们对 454 名参与者的磁共振成像（MRI）和淀粉样蛋白正电子发射断层扫描（PET）进行了深入分析，重点研究了白质模式和白质组间变异性（WM-ISV）。
结果
MRI 和淀粉样蛋白 PET 相结合的白质模式集合模型在认知障碍和残疾的分类性能上表现出显著提高。阿尔茨海默病（AD）患者的 WM-ISV 高于主观认知下降、轻度认知障碍和血管性痴呆患者。此外，WM-ISV 与血液生物标志物（如神经胶质纤维酸性蛋白和磷酸化 tau-217[p-tau217]）以及认知功能和残疾评分显著相关。
讨论
我们的研究结果表明，白质模式分析具有作为临床决策和确定认知障碍和残疾的辅助神经影像学生物标志物的重要潜力。
重点
集合模型结合了磁共振成像（MRI）和淀粉样蛋白正电子发射断层扫描（PET），在认知障碍和残疾的分类性能上表现出显著提高。与主观认知下降、轻度认知障碍或血管性痴呆相比，阿尔茨海默病（AD）患者的组间变异性明显更高。白质组间变异性（WM-ISV）与血液生物标志物（神经胶质纤维酸性蛋白和磷酸化 tau-217[p-tau217]）和 AD 的多基因风险评分显著相关。白质模式分析具有作为临床决策过程和确定认知障碍和残疾的辅助神经影像学生物标志物的重要潜力。
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