Medial temporal atrophy predicts the limbic comorbidities in lewy body disease.

IF 2.4 3区医学 Q2 CLINICAL NEUROLOGY Neuroradiology Pub Date : 2024-11-12 DOI:10.1007/s00234-024-03502-z

Keita Sakurai, Daita Kaneda, Satoru Morimoto, Yuto Uchida, Shohei Inui, Cong Shang, Yasuyuki Kimura, Chang Cai, Takashi Kato, Kengo Ito, Yoshio Hashizume

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Abstract

Purpose: Although neuropathological comorbidities, including Alzheimer's disease neuropathological change (AD-NC) and limbic-predominant age-related TAR DNA-binding protein 43encephalopathy neuropathological change (LATE-NC), are associated with medial temporal atrophy in patients with Lewy body disease (LBD), the diagnostic performance of magnetic resonance imaging (MRI)-derived indices remains unclear. This study aimed to investigate the diagnostic performance of MRI-derived indices representing medial temporal atrophy in differentiating between LBD with AD-NC and/or LATE-NC (mixed LBD [mLBD]) and without these comorbidities (pure LBD [pLBD]).

Methods: This study included 24 and 16 patients with pathologically confirmed mLBD and pLBD, respectively. In addition to the well-known medial temporal atrophy and entorhinal cortex atrophy (ERICA) scores, the cross-sectional areas of the bilateral entorhinal cortices/parahippocampal gyri (ABEP) were segmented manually.

Results: Even incorporating various covariates such as age at MRI examination, sex, argyrophilic grain, the MRI-derived indices, especially ABEP, significantly correlated with the severity of AD-NC, and showed a trend of correlation with LATE-NC. For the differentiation between all mLBD and pLBD, the ERICA score and ABEP demonstrated higher diagnostic performance (area under the receiver-operating-characteristic curve [AUC] of 0.80 and 0.87, respectively). Additionally, the highest diagnostic performance for ABEP (AUC, 0.94; sensitivity, 100%; specificity, 88.9%; accuracy, 96%) was observed in differentiating between pLBD and mLBD with two comorbidities (AD-NC and LATE-NC).

Conclusion: In patients with pathologically confirmed LBD, medial temporal atrophy was significantly correlated with AD-NC, and showed a trend of correlation with LATE-NC. Moreover, MRI-derived indices indicative of medial temporal atrophy were useful in diagnosing these comorbidities.

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颞叶内侧萎缩可预测lewy体病的边缘合并症。

目的：尽管神经病理学合并症，包括阿尔茨海默病神经病理学改变（AD-NC）和边缘主导型年龄相关TAR DNA结合蛋白43encephalopathy神经病理学改变（LATE-NC）与路易体病（LBD）患者的颞叶内侧萎缩有关，但磁共振成像（MRI）衍生指数的诊断性能仍不清楚。本研究旨在探讨代表颞叶内侧萎缩的磁共振成像衍生指标在区分LBD伴有AD-NC和/或LATE-NC（混合型LBD [mLBD]）和不伴有这些合并症（纯LBD [pLBD]）时的诊断性能：本研究分别纳入了 24 名和 16 名经病理证实的 mLBD 和 pLBD 患者。除了众所周知的颞叶内侧萎缩和内侧皮质萎缩（ERICA）评分外，还对双侧内侧皮质/海马旁回（ABEP）的横截面积进行了人工分割：结果：即使将核磁共振成像检查时的年龄、性别、霰粒肿等各种协变量考虑在内，核磁共振成像得出的指数，尤其是ABEP，仍与AD-NC的严重程度显著相关，并与晚期AD-NC呈相关趋势。在区分所有 mLBD 和 pLBD 时，ERICA 评分和 ABEP 表现出更高的诊断性能（接收器操作特征曲线下面积 [AUC] 分别为 0.80 和 0.87）。此外，ABEP的诊断性能最高（AUC，0.94；灵敏度，100%；特异性，88.9%；准确性，96%），可区分pLBD和有两种合并症（AD-NC和LATE-NC）的mLBD：结论：在病理确诊的枸杞多糖症患者中，颞叶内侧萎缩与AD-NC显著相关，并呈现出与LATE-NC相关的趋势。此外，核磁共振成像得出的颞叶内侧萎缩指标有助于诊断这些合并症。

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.