Abstract
The objective of this study was to evaluate susceptibility changes caused by iron accumulation in cognitive normal (CN) elderly, those with amnestic mild cognitive impairment (aMCI), and those with early state AD, and to compare the findings with gray matter volume (GMV) changes caused by neuronal loss. The participants included 19 elderly CN, 19 aMCI, and 19 AD subjects. The voxel-based quantitative susceptibility map (QSM) and GMV in the brain were calculated and the differences of those insides were compared among the three groups. The differences of the QSM data and GMVs among the three groups were investigated by voxel-based and region of interest (ROI)-based comparisons using a one-way analysis of covariance (ANCOVA) test with the gender and age as covariates. Finally, a receiver-operating-characteristic (ROC) curve analysis was performed. The voxel-based results showed that QSM demonstrated more areas with significant difference between the CN and AD groups compared to GMV. GMVs were decreased, but QSM values were increased in aMCI and AD groups compared with the CN group. QSM better differentiated aMCI from CN than GMV in the precuneus and allocortex regions. In the accumulation regions of iron and amyloid β, QSM can be used to differentiate between CN and aMCI groups, indicating a useful an auxiliary imaging for early diagnosis of AD.
Highlights
Alzheimer's disease (AD) is the most common progressive and complex age-related neurodegenerative disorder, leading to cognitive decline (Albertini et al, 2012) and memory loss (Jahn, 2013)
The objective of this study was to systematically investigate the susceptibility changes in subjects of cognitive normal (CN), amnestic mild cognitive impairment (aMCI), and early stage AD using voxel-based analysis and region of interest (ROI)-based analysis, and to compare the data to gray matter volume (GMV) changes caused by neuronal losses in the subjects
Based on the results of Seoul Neuropsychological Screening Battery (SNSB) examination and MRI findings, CN were selected from healthy volunteers who did not have a medical history of neurological disease, who showed normal results on detailed cognitive testing scores that were within 1 standard deviation (SD) adjusted for age, gender, and education according to the Korean normative database, and who had a normal brain MRI
Summary
Alzheimer's disease (AD) is the most common progressive and complex age-related neurodegenerative disorder, leading to cognitive decline (Albertini et al, 2012) and memory loss (Jahn, 2013). Mild cognitive impairment (MCI) is a high-risk condition for the development of clinically probable AD or other neurological conditions (Petersen et al, 2001). The hallmarks of AD may manifest as alterations of susceptibility in a certain area in the brain, caused by associated iron overload (Haacke et al, 2005), and demyelination of white matter (Carmeli et al, 2014). Loss of myelin causes the susceptibility of white matter to increase, approaching that of gray matter (Lee et al, 2012). Both demyelination and iron deposition increase local tissue susceptibility (Liu et al, 2015). Elevated levels of brain iron have been suggested to be a risk factor for AD (Duce et al, 2010; Ayton et al, 2015)
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