Torso Mario, Khosropanah Pegah, Chance Steven A, Ridgway Gerard R
Oxford Brain Diagnostics Ltd, Oxford, UK.
Alzheimers Dement. 2025 May;21(5):e70310. doi: 10.1002/alz.70310.
This study evaluates the capability of cortical microstructural measures from diffusion magnetic resonance imaging (MRI) to predict progression from mild cognitive impairment (MCI) to dementia, compared to commonly used macrostructural measures. Identification of high-risk individuals can support both clinical practice and trials.
Structural and diffusion MRI scans of 826 participants from the National Alzheimer's Coordinating Center (NACC) were analyzed to extract macrostructural measures and three minicolumn-related diffusivity metrics: AngleR, PerpPD, and ParlPD. Kaplan-Meier survival analysis was used to investigate time to progression to dementia, with participants stratified by biomarker metrics.
Cortical diffusivity (PerpPD in medial-temporal and connected regions) outperformed hippocampal volume, cortical volume, and cortical thickness in Kaplan-Meier survival analysis, predicting faster conversion to dementia.
Cortical microstructural measures from diffusion MRI provide powerful biomarkers for predicting progression from MCI to dementia, offering enhanced prognostic capabilities that could support earlier intervention strategies in clinical practice and improve the power of clinical trials.
Cortical minicolumn-related diffusivity metrics measure neurodegeneration. We compare the predictive value of magnetic resonance imaging (MRI) measures for mild cognitive impairment to dementia progression. Microstructural cortical disarray outperforms macrostructural markers. These results support using diffusion MRI biomarkers to identify and monitor at-risk patients.
本研究评估了与常用的宏观结构测量方法相比，基于扩散磁共振成像（MRI）的皮质微结构测量方法预测从轻度认知障碍（MCI）进展为痴呆症的能力。识别高危个体可为临床实践和试验提供支持。
对来自国家阿尔茨海默病协调中心（NACC）的826名参与者的结构和扩散MRI扫描进行分析，以提取宏观结构测量值和三个与微柱相关的扩散率指标：AngleR、PerpPD和ParlPD。采用Kaplan-Meier生存分析来研究进展为痴呆症的时间，并根据生物标志物指标对参与者进行分层。
在Kaplan-Meier生存分析中，皮质扩散率（内侧颞叶及相连区域的PerpPD）在预测进展为痴呆症的速度方面优于海马体积、皮质体积和皮质厚度。
基于扩散MRI的皮质微结构测量方法为预测从MCI进展为痴呆症提供了强大的生物标志物，具有更强的预后能力，可支持临床实践中的早期干预策略，并提高临床试验的效能。
与皮质微柱相关的扩散率指标可测量神经退行性变。我们比较了磁共振成像（MRI）测量方法对轻度认知障碍进展为痴呆症的预测价值。微结构皮质紊乱优于宏观结构标志物。这些结果支持使用扩散MRI生物标志物来识别和监测高危患者。
