J Korean Med Sci.  2023 Oct;38(41):e316. 10.3346/jkms.2023.38.e316.

Textural and Volumetric Changes of the Temporal Lobes in Semantic Variant Primary Progressive Aphasia and Alzheimer’s Disease

• Kwon MJ
• Lee S
• Park J
• Jo S
• Han JW
• Oh DJ
• Lee JY
• Park JH
• Kim JH
• Kim KW

• KMID: 2547174
• DOI: http://doi.org/10.3346/jkms.2023.38.e316

Abstract

Background
Texture analysis may capture subtle changes in the gray matter more sensitively than volumetric analysis. We aimed to investigate the patterns of neurodegeneration in semantic variant primary progressive aphasia (svPPA) and Alzheimer’s disease (AD) by comparing the temporal gray matter texture and volume between cognitively normal controls and older adults with svPPA and AD.
Methods
We enrolled all participants from three university hospitals in Korea. We obtained T1-weighted magnetic resonance images and compared the gray matter texture and volume of regions of interest (ROIs) between the groups using analysis of variance with Bonferroni posthoc comparisons. We also developed models for classifying svPPA, AD and control groups using logistic regression analyses, and validated the models using receiver operator characteristics analysis.
Results
Compared to the AD group, the svPPA group showed lower volumes in five ROIs (bilateral temporal poles, and the left inferior, middle, and superior temporal cortices) and higher texture in these five ROIs and two additional ROIs (right inferior temporal and left entorhinal cortices). The performances of both texture- and volume-based models were good and comparable in classifying svPPA from normal cognition (mean area under the curve [AUC] = 0.914 for texture; mean AUC = 0.894 for volume). However, only the texture-based model achieved a good level of performance in classifying svPPA and AD (mean AUC = 0.775 for texture; mean AUC = 0.658 for volume).
Conclusion
Texture may be a useful neuroimaging marker for early detection of svPPA in older adults and its differentiation from AD.

Keyword

Semantic Variant Primary Progressive Aphasia; Alzheimer’s Disease; MRI; Texture; Volume; Temporal Lobe

Figure

• 

  Fig. 1 Z-score map of regional volume and texture changes in the AD and svPPA groups. (A) Regional volume changes in each clinical group compared to the control group. (B) Regional texture changes in each clinical group compared to the control group.AD = Alzheimer’s disease, svPPA = semantic variant primary progressive aphasia.

• 

  Fig. 2 Comparison of the performance of the texture- and volume-based models for differentiating patients with semantic variant primary progressive aphasia from cognitively normal controls and patients with AD. (A) Models for differentiating patients with semantic variant primary progressive aphasia from cognitively normal controls. (B) Models for differentiating patients with semantic variant primary progressive aphasia from those with AD.AUC = area under the receiver operating characteristic curve, CI = confidence interval, AD = Alzheimer’s disease.

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