J Korean Med Sci.  2015 Jun;30(6):779-787. 10.3346/jkms.2015.30.6.779.

Comparison of Regional Gray Matter Atrophy, White Matter Alteration, and Glucose Metabolism as a Predictor of the Conversion to Alzheimer's Disease in Mild Cognitive Impairment

• Sohn BK
• Yi D
• Seo EH
• Choe YM
• Kim JW
• Kim SG
• Choi HJ
• Byun MS
• Jhoo JH
• Woo JI
• Lee DY

• KMID: 2160608
• DOI: http://doi.org/10.3346/jkms.2015.30.6.779

Abstract

We compared the predictive ability of the various neuroimaging tools and determined the most cost-effective, non-invasive Alzheimer's disease (AD) prediction model in mild cognitive impairment (MCI) individuals. Thirty-two MCI subjects were evaluated at baseline with [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET), MRI, diffusion tensor imaging (DTI), and neuropsychological tests, and then followed up for 2 yr. After a follow up period, 12 MCI subjects converted to AD (MCIc) and 20 did not (MCInc). Of the voxel-based statistical comparisons of baseline neuroimaging data, the MCIc showed reduced cerebral glucose metabolism (CMgl) in the temporo-parietal, posterior cingulate, precuneus, and frontal regions, and gray matter (GM) density in multiple cortical areas including the frontal, temporal and parietal regions compared to the MCInc, whereas regional fractional anisotropy derived from DTI were not significantly different between the two groups. The MCIc also had lower Mini-Mental State Examination (MMSE) score than the MCInc. Through a series of model selection steps, the MMSE combined with CMgl model was selected as a final model (classification accuracy 93.8%). In conclusion, the combination of MMSE with regional CMgl measurement based on FDG-PET is probably the most efficient, non-invasive method to predict AD in MCI individuals after a two-year follow-up period.

Keyword

Alzheimer Disease; Prediction; FDG-PET; MRI; Diffusion Tensor Imaging; Mini-Mental State Examination

MeSH Terms

Aged
Alzheimer Disease/complications/*diagnosis
Atrophy/pathology
Biomarkers/blood
Brain/*pathology
Diffusion Tensor Imaging/methods
Female
Glucose/*metabolism
Gray Matter/*pathology
Humans
Male
Mild Cognitive Impairment/*diagnosis/etiology
Neuroimaging/methods
Positron-Emission Tomography/methods
Reproducibility of Results
Sensitivity and Specificity
Severity of Illness Index
White Matter/*pathology
Biomarkers
Glucose

Figure

• 

  Fig. 1 Brain regions showing lower glucose metabolism in the mild cognitive impairment (MCI) converted to Alzheimer's disease compare to the non-converted MCI at baseline, P < 0.005, uncorrected; voxel extent threshold 50.

• 

  Fig. 2 Brain regions showing decreased gray matter density in the mild cognitive impairment (MCI) converted to Alzheimer's disease compare to the non-converted MCI at baseline, P < 0.005, uncorrected; voxel extent threshold 50.

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