The role of visual rating and automated brain volumetry in early detection and differential diagnosis of Alzheimer's disease

IF 4.8 1区医学 Q1 NEUROSCIENCES CNS Neuroscience & Therapeutics Pub Date : 2023-10-21 DOI:10.1111/cns.14492

Yingren Mai, Zhiyu Cao, Lei Zhao, Qun Yu, Jiaxin Xu, Wenyan Liu, Bowen Liu, Jingyi Tang, Yishan Luo, Wang Liao, Wenli Fang, Yuting Ruan, Ming Lei, Vincent C. T. Mok, Lin Shi, Jun Liu, for the Alzheimer's Disease Neuroimaging Initiative

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Abstract

Background

Medial temporal lobe atrophy (MTA) is a diagnostic marker for mild cognitive impairment (MCI) and Alzheimer's disease (AD), but the accuracy of quantitative MTA (QMTA) in diagnosing early AD is unclear. This study aimed to investigate the accuracy of QMTA and its related components (inferior lateral ventricle [ILV] and hippocampus) with MTA in the early diagnosis of MCI and AD.

Methods

This study included four groups: normal (NC), MCI stable (MCIs), MCI converted to AD (MCIs), and mild AD (M-AD) groups. Magnetic resonance image analysis software was used to quantify the hippocampus, ILV, and QMTA. MTA was rated by two experienced neurologists. Receiver operating characteristic area under the curve (AUC) analysis was performed to compare their capability in differentiating AD from NC and MCI, and optimal thresholds were determined using the Youden index.

Results

QMTA distinguished M-AD from NC and MCI with higher diagnostic accuracy than MTA, hippocampus, and ILV (AUC_NC = 0.976, AUC_MCI = 0.836, AUC_MCIs = 0.894, AUC_MCIc = 0.730). The diagnostic accuracy of QMTA was superior to that of MTA, the hippocampus, and ILV in differentiating MCI from AD. The diagnostic accuracy of QMTA was found to remain the best across age, sex, and pathological subgroups analyzed. The sensitivity (92.45%) and specificity (90.64%) were higher in this study when a cutoff value of 0.635 was chosen for QMTA.

Conclusions

QMTA may be a better choice than the MTA scale or the associated quantitative components alone in identifying AD patients and MCI individuals with higher progression risk.

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视觉评分和自动脑容量测定在阿尔茨海默病早期检测和鉴别诊断中的作用。

背景：颞叶内侧萎缩（MTA）是轻度认知障碍（MCI）和阿尔茨海默病（AD）的诊断标志物，但定量MTA（QMTA）诊断早期AD的准确性尚不清楚。本研究旨在探讨QMTA及其相关成分（下侧脑室[ILV]和海马）与MTA在MCI和AD早期诊断中的准确性。磁共振图像分析软件用于量化海马体、ILV和QMTA。MTA由两位经验丰富的神经学家评定。进行受试者工作特征曲线下面积（AUC）分析，以比较其区分AD、NC和MCI的能力，并使用Youden指数确定最佳阈值。结果：QMTA将M-AD与NC和MCI区分开来，其诊断准确率高于MTA、海马和ILV（AUCNC = 0.976，AUCMCI = 0.836，AUCMC = 0.894，AUMCIc = 0.730）。在区分MCI和AD方面，QMTA的诊断准确性优于MTA、海马体和ILV。QMTA在年龄、性别和分析的病理亚组中的诊断准确性仍然最好。当QMTA的截止值为0.635时，本研究的敏感性（92.45%）和特异性（90.64%）更高。结论：在识别进展风险更高的AD患者和MCI个体时，QMTA可能比MTA量表或单独的相关定量成分更好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.