How may brain MRI predict the development of Alzheimer’s disease?

 Presymptomatic cortical thinning in familial Alzheimer disease: a longitudinal MRI study

Weston PS, Nicholas JM, Lehmann M, et al.

Neurology 2016; 87:2050-2057.

Abstract

OBJECTIVES:

To identify a cortical signature pattern of cortical thinning in familial Alzheimer disease (FAD) and assess its utility in detecting and tracking presymptomatic neurodegeneration.

METHODS:

We recruited 43 FAD mutation carriers—36 PSEN1, 7 APP (20 symptomatic, 23 presymptomatic)—and 42 healthy controls to a longitudinal clinical and MRI study. T1-weighted MRI scans were acquired at baseline in all participants; 55 individuals (33 mutation carriers; 22 controls) had multiple (mean 2.9) follow-up scans approximately annually. Cortical thickness was measured using FreeSurfer. A cortical thinning signature was identified from symptomatic FAD participants. We then examined cortical thickness changes in this signature region in presymptomatic carriers and assessed associations with cognitive performance.

RESULTS:

The cortical signature included 6 regions: entorhinal cortex, inferior parietal cortex, precuneus, superior parietal cortex, superior frontal cortex, and supramarginal gyrus. There were significant differences in mean cortical signature thickness between mutation carriers and controls 3 years before predicted symptom onset. The earliest significant difference in a single region, detectable 4 years preonset, was in the precuneus. Rate of change in cortical thickness became significantly different in the cortical signature at 5 years before predicted onset, and in the precuneus at 8 years preonset. Baseline mean signature thickness predicted rate of subsequent thinning and correlated with presymptomatic cognitive change.

CONCLUSIONS:

The FAD cortical signature appears to be similar to that described for sporadic AD. All component regions showed significant presymptomatic thinning. A composite signature may provide more robust results than a single region and have utility as an outcome measure in presymptomatic trials.

You may also check

The cortical signature of prodromal AD: regional thinning predicts mild AD dementia.

Bakkour A,Morris JC, Dickerson BC.

Neurology 2009; 72:1048–1055.

Both references are now included in the neurochecklist:

Alzheimer’s disease (AD): clinical features

screen-shot-2016-12-24-at-23-32-53

Abstract link

By US National Institute on Aging, Alzheimer's Disease Education and Referral Center - http://www.nia.nih.gov/Alzheimers/Resources/HighRes.htm, Public Domain, Link
By US National Institute on Aging, Alzheimer’s Disease Education and Referral Center – http://www.nia.nih.gov/Alzheimers/Resources/HighRes.htm, Public Domain, Link
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