The Combination of Functional and Structural MRI Is a Potential Screening Tool in Alzheimer's Disease.

Wei-Ming Huang,Chun-Chao Huang,Chia-Hung Chen,The Alzheimer’s Disease Neuroimaging Initiative The Alzheimer’s Disease Neuroimaging Initiative,Ching-Po Lin,Zong-Yi Jhou

doi:10.3389/fnagi.2018.00251

Abstract

Introduction: This study aimed to survey the discrimination power of parameters from cerebrospinal fluid (CSF) biomarkers, fluorodeoxyglucose uptake on PET (FDG-PET), structural magnetic resonance imaging (MRI), and functional MRI in high- and low-risk subjects or in converters and stable subjects of normal and mild cognitive impairment (MCI) statuses.Methods: We used baseline resting-state functional MRI (rfMRI) from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) dataset to analyze functional networks and recorded subjects’ characteristics and results of the CSF study, FDG-PET, and structural MRI from the ADNI website. All parameters were evaluated based on the between-group difference among normal (NC), MCI, and Alzheimer’s disease (AD) groups. The parameters other than CSF results were included to study the difference between high- and low-AD-risk subjects in NC or MCI groups, based on CSF results. On the basis of two-year follow-up conditions, all parameters were compared between stable subjects and converters in NC and MCI.Results: CSF biomarkers, FDG-PET, structural MRI, and functional MRI are all able to differentiate AD from MCI or NC but not between MCI and NC. As compared with low-AD-risk subjects, high-risk subjects present decreased FDG-PET in both MCI and NC groups but structural MRI change only in MCI status and rfMRI alteration only in NC status. As compared with stable subjects, converters have decreased FDG-PET, functional network changes, and structural changes in both MCI and NC groups.Conclusion: The combination of functional and structural MRI is a safer screening tool but with similar power as FDG-PET to reflect CSF change in the AD pathological process and to identify high-risk subjects and converters in NC and MCI.

Highlights

This study aimed to survey the discrimination power of parameters from cerebrospinal fluid (CSF) biomarkers, fluorodeoxyglucose uptake on PET (FDG-PET), structural magnetic resonance imaging (MRI), and functional MRI in high- and low-risk subjects or in converters and stable subjects of normal and mild cognitive impairment (MCI) statuses
For the CSF data, a significantly lower value of Aβ42 and higher values of total tau (T-tau), phosphorylated tau (P-tau), P-tau/Aβ42, and T-tau/Aβ42 were noted in Alzheimer’s disease (AD) as compared with NC or MCI; there was no significant difference of the above parameters between NC and MCI
The FDG-PET result showed a significantly lower value in AD as compared with NC or MCI, but there was no significant difference between NC and MCI

Summary

Introduction

This study aimed to survey the discrimination power of parameters from cerebrospinal fluid (CSF) biomarkers, fluorodeoxyglucose uptake on PET (FDG-PET), structural magnetic resonance imaging (MRI), and functional MRI in high- and low-risk subjects or in converters and stable subjects of normal and mild cognitive impairment (MCI) statuses. Considering that the pathological process begins to occur years or even decades before clinical diagnosis of AD (Hulette et al, 1998; Price and Morris, 1999; Price et al, 2009), the goal of therapeutic strategies is currently focused on prevention with intervention initiated as early as possible, even in preclinical stage (Cummings et al, 2007; Fagan et al, 2011; Sperling et al, 2011b). The achievement of this goal relies on specific biomarkers, which can early detect subjects at risk. PET amyloid imaging and the combination change of CSF Aβ42 and tau are included in the criteria to diagnose AD or to detect subjects at risk (Dubois et al, 2014)

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