RT Journal Article
SR Electronic
T1 Can MRI screen for CSF biomarkers in neurodegenerative disease?
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 132
OP 138
DO 10.1212/WNL.0b013e31827b9147
VO 80
IS 2
A1 Corey T. McMillan
A1 Brian Avants
A1 David J. Irwin
A1 Jon B. Toledo
A1 David A. Wolk
A1 Vivianna M. Van Deerlin
A1 Leslie M. Shaw
A1 John Q. Trojanoswki
A1 Murray Grossman
YR 2013
UL http://n.neurology.org/content/80/2/132.abstract
AB Objective: Alzheimer disease (AD) and frontotemporal lobar degeneration (FTLD) may have overlapping clinical presentations despite distinct underlying neuropathologies, thus making in vivo diagnosis challenging. In this study, we evaluate the utility of MRI as a noninvasive screening procedure for the differential diagnosis of AD and FTLD.Methods: We recruited 185 patients with a clinically diagnosed neurodegenerative disease consistent with AD or FTLD who had a lumbar puncture and a volumetric MRI. A subset of 32 patients had genetic or autopsy-confirmed AD or FTLD. We used singular value decomposition to decompose MRI volumes and linear regression and cross-validation to predict CSF total tau (tt) and β-amyloid (Aβ1-42) ratio (tt/Aβ) in patients with AD and patients with FTLD. We then evaluated accuracy of MRI-based predicted tt/Aβ using 4 converging sources including neuroanatomic visualization and categorization of a subset of patients with genetic or autopsy-confirmed AD or FTLD.Results: Regression analyses showed that MRI-predicted tt/Aβ is highly related to actual CSF tt/Aβ. In each group, both predicted and actual CSF tt/Aβ have extensively overlapping neuroanatomic correlates: low tt/Aβ consistent with FTLD is related to ventromedial prefrontal regions while high tt/Aβ consistent with AD is related to posterior cortical regions. MRI-predicted tt/Aβ is 75% accurate at identifying underlying diagnosis in patients with known pathology and in clinically diagnosed patients with known CSF tt/Aβ levels.Conclusion: MRI may serve as a noninvasive procedure that can screen for AD and FTLD pathology as a surrogate for CSF biomarkers.Aβ=β-amyloid; AD=Alzheimer disease; FTLD=frontotemporal lobar degeneration; GM=gray matter; ROI=region of interest; SVD=singular value decomposition; tt=total tau