Effectiveness of regional DTI measures in distinguishing Alzheimer’s disease, MCI, and normal aging
Open accessAbstract
The Alzheimer's Disease Neuroimaging Initiative (ADNI) recently added diffusion tensor imaging (DTI), among several other new imaging modalities, in an effort to identify sensitive biomarkers of Alzheimer's disease (AD). While anatomical MRI is the main structural neuroimaging method used in most AD studies and clinical trials, DTI is sensitive to microscopic white matter (WM) changes not detectable with standard MRI, offering additional markers of neurodegeneration. Prior DTI studies of AD report lower fractional anisotropy (FA), and increased mean, axial, and radial diffusivity (MD, AxD, RD) throughout WM. Here we assessed which DTI measures may best identify differences among AD, mild cognitive impairment (MCI), and cognitively healthy elderly control (NC) groups, in region of interest (ROI) and voxel-based analyses of 155 ADNI participants (mean age: 73.5 ± 7.4; 90 M/65 F; 44 NC, 88 MCI, 23 AD). Both VBA and ROI analyses revealed widespread group differences in FA and all diffusivity measures. DTI maps were strongly correlated with widely-used clinical ratings (MMSE, CDR-sob, and ADAS-cog). When effect sizes were ranked, FA analyses were least sensitive for picking up group differences. Diffusivity measures could detect more subtle MCI differences, where FA could not. ROIs showing strongest group differentiation (lowest p-values) included tracts that pass through the temporal lobe, and posterior brain regions. The left hippocampal component of the cingulum showed consistently high effect sizes for distinguishing groups, across all diffusivity and anisotropy measures, and in correlations with cognitive scores.
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Among the three cognitive assessments, CDR-sob showed the strongest correlations with dMRI indices, in line with prior ADNI brain imaging studies.
“Among the three cognitive assessments, CDR-sob showed the strongest correlations with dMRI indices, in line with prior ADNI brain imaging studies (Hua et al., 2009; Nir et al., 2013).”
From Diffusion MRI Indices and Their Relation to Cognitive Impairment in Brain Aging: The Updated Multi-protocol Approach in ADNI3 (2019) · cites this paper as Nir et al., 2013
The Discussion reports that CDR-sob was the most widely correlated of the three assessments with diffusivity in the MCI group, in both voxel-based and ROI analyses. It does not establish that CDR-sob had the strongest correlations with dMRI indices across the full cohort or across all dMRI measures, as the unqualified claim implies. Page numbers are unavailable in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn ADNI2, AxDDTI was the most sensitive to differences between CN and MCI diagnosis.
“Similarly, in ADNI2, AxDDTI was the most sensitive to differences between CN and MCI diagnosis (Nir et al., 2013).”
From Diffusion MRI Indices and Their Relation to Cognitive Impairment in Brain Aging: The Updated Multi-protocol Approach in ADNI3 (2019) · cites this paper as Nir et al., 2013
The Discussion (page unavailable) reports slightly larger effect sizes for axial diffusivity (AxD) when comparing controls with MCI in full-ROI analyses, supporting the sensitivity comparison. The claim omits that analysis-specific qualifier: the Results, under Voxel-based analyses (page unavailable), found no significant difference between controls and MCI as a whole for any DTI measure. (LLM, conf=0.83)
Experimental — accuracy not yet measuredAs in prior analysis of ADNI2, FADTI was the least sensitive DTI measure.
“As in our prior analysis of ADNI2 (Nir et al., 2013), FADTI was the least sensitive DTI measure.”
From Diffusion MRI Indices and Their Relation to Cognitive Impairment in Brain Aging: The Updated Multi-protocol Approach in ADNI3 (2019) · cites this paper as Nir et al., 2013
dMRI has been used in numerous studies to understand the effects of AD on white matter microstructure and brain connectivity.
“dMRI has since been used in numerous studies to understand the effects of AD on white matter (WM) microstructure and brain connectivity (Daianu et al., 2013a,b; Nir et al., 2013; Prasad et al., 2013).”
From Diffusion MRI Indices and Their Relation to Cognitive Impairment in Brain Aging: The Updated Multi-protocol Approach in ADNI3 (2019) · cites this paper as Nir et al., 2013
Lower FADTI and higher MDDTI are most frequently reported in studies of AD.
“Lower FADTI and higher MDDTI are most frequently reported in studies of AD (Kavcic et al., 2008; Clerx et al., 2012; Nir et al., 2013; Maggipinto et al., 2017; Mayo et al., 2017)”
From Diffusion MRI Indices and Their Relation to Cognitive Impairment in Brain Aging: The Updated Multi-protocol Approach in ADNI3 (2019) · cites this paper as Nir et al., 2013
These regions show early degenerative changes in MCI and AD.
“These are all regions that show early degenerative changes in MCI and AD (Mielke et al., 2009; Nir et al., 2013; Maggipinto et al., 2017; Powell et al., 2018).”
From Diffusion MRI Indices and Their Relation to Cognitive Impairment in Brain Aging: The Updated Multi-protocol Approach in ADNI3 (2019) · cites this paper as Nir et al., 2013
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White matter correlates of cognitive domains in normal aging with diffusion tensor imaging
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Self-citationGenetic influences on brain asymmetry: A DTI study of 374 twins and siblings
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Self-citationClerx, L., Visser, P. J., Verhey, F., & Aalten, P. (2012) · Journal of Alzheimer s Disease · doi:10.3233/jad-2011-110797 · Cited by 132 · see citing works
Diffusion Tensor Metrics as Biomarkers in Alzheimer's Disease
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White matter lesions and hippocampal atrophy in Alzheimer’s disease
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Automated MRI measures predict progression to Alzheimer's disease
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Self-citationA study of diffusion tensor imaging by tissue-specific, smoothing-compensated voxel-based analysis
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The tensor distribution function
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Structural Magnetic Resonance Imaging in Established and Prodromal Alzheimer Disease: A Review
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Selective Disruption of the Cerebral Neocortex in Alzheimer's Disease
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Self-citationWhite matter atrophy in Alzheimer's disease variants
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How does angular resolution affect diffusion imaging measures?
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Self-citationGutman, B., Hua, X., Rajagopalan, P., Chou, Y., Wang, Y.-L., Yanovsky, I., Toga, A., Jack, C., Weiner, M., & Thompson, P. (2013) · NeuroImage · doi:10.1016/j.neuroimage.2012.12.052 · Cited by 76 · see citing works
Self-citationGuzman, V. A., Carmichael, O. T., Schwarz, C. G., Tosto, G., Zimmerman, M. E., Brickman, A. M., & Initiative, A. D. N. (2013) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2012.11.009 · Cited by 74 · see citing works
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Self-citationWhite matter integrity linked to functional impairments in aging and early Alzheimer’s disease
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Angular versus spatial resolution trade-offs for diffusion imaging under time constraints
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Self-citationTopology Preserving Log-Unbiased Nonlinear Image Registration: Theory and Implementation
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Self-citationAlzheimer's disease disrupts rich club organization in brain connectivity networks
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Blood pressure and cerebral white matter share common genetic factors in Mexican Americans
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Magnetic Resonance Approaches to Brain Aging and Alzheimer Disease-associated Neuropathology
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Tractography density and network measures in Alzheimer’s disease
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Self-citationIncorrect ICBM-DTI-81 atlas orientation and white matter labels
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Self-citationVisualization Tools for High Angular Resolution Diffusion Imaging
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Self-citationConnectomics Sheds New Light on Alzheimer’s Disease
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Self-citationZhan, L., Leow, A., Aganj, I., Lenglet, C., Sapiro, G., Yacoub, E. S., Harel, N., Toga, A. W., & Thompson, P. M. (2011) · IEEE International Symposium on Biomedical Imaging (ISBI) · doi:10.1109/isbi.2011.5872411 · Cited by 23 · see citing works
Self-citationHow do spatial and angular resolution affect brain connectivity maps from diffusion MRI?
Zhan, L., Franc, D. T., Patel, V. N., Jahanshad, N., Jin, Y., Mueller, B. A., Bernstein, M. A., Borowski, B., Jack, C. R., Toga, A. W., et al. (2012) · IEEE International Symposium on Biomedical Imaging (ISBI) · doi:10.1109/isbi.2012.6235469 · Cited by 22 · see citing works
Self-citationLi, W.-B., Zhang, Y.-Z., Chang, C., Wei, X., & Fu, J. (2011) · Neurology India · doi:10.4103/0028-3886.79129 · Cited by 22 · see citing works
A Novel Measure of Fractional Anisotropy Based on the Tensor Distribution Function
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Self-citationHow Many Gradients are Sufficient in High-Angular Resolution Diffusion Imaging (HARDI)?
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Self-citationNir, T. M., Jahanshad, N., Toga, A. W., Jack, C. R., Weiner, M. W., & Thompson, P. M. (2012) · Lecture notes in computer science · doi:10.1007/978-3-642-33530-3_4 · Cited by 6 · see citing works
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“We hypothesized that the diffusion indices from ADNI2 (Nir et al., 2013, 2017) would still be associated with clinical measures of disease burden in ADNI3—despite the variation in protocols.”
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- Authors
- Nir, T. M., Jahanshad, N., Villalon-Reina, J. E., Toga, A. W., Jack, C. R., Weiner, M. W., & Thompson, P. M.
- Affiliations
- University of California, Los Angeles (US)
- Mayo Clinic (US)
- University of California, San Francisco (US)
- Corresponding author
- Thompson, Paul M.
- ORCID
- Venue
- NeuroImage: Clinical
- Publisher
- Elsevier BV
- Published
- 2013
- Volume
- 3
- Pages
- 180-195
- ISSN
- 2213-1582 (ISSN-L)
- PMC
- PMC3792746
- OpenAlex
- W2028748733
- Cited by
- 348
- References
- 131
- Citations by year
- 2026: 14 · 2025: 37 · 2024: 28 · 2023: 33 · 2022: 29 · 2021: 31 · 2020: 23 · 2019: 32 · 2018: 22 · 2017: 21 · 2016: 27 · 2015: 30 · 2014: 21
- FWCI
- 18.49
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- NeuroImage Clinical (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc-nd)
- Funders
- ADNI (U01 AG024904)
- National Institute on Aging
- National Institute of Biomedical Imaging and Bioengineering
- Abbott
- Alzheimer's Association
- Alzheimer's Drug Discovery Foundation
- Amorfix Life Sciences Ltd.
- AstraZeneca
- Bayer HealthCare
- BioClinica, Inc.
- Biogen Idec Inc.
- Bristol-Myers Squibb Company
- Eisai Inc.
- Elan Pharmaceuticals Inc.
- Eli Lilly and Company
- F. Hoffmann-La Roche Ltd.
- Genentech, Inc.
- GE Healthcare
- Innogenetics, N.V.
- IXICO Ltd.
- Janssen Alzheimer Immunotherapy Research & Development, LLC.
- Johnson & Johnson Pharmaceutical Research & Development LLC.
- Medpace, Inc.
- Merck & Co., Inc.
- Meso Scale Diagnostics, LLC.
- Novartis Pharmaceuticals Corporation
- Pfizer Inc.
- Servier
- Synarc Inc.
- Takeda Pharmaceutical Company
- Canadian Institutes of Health Research
- NIH (P30 AG010129, K01 AG030514)
- NIA
- NIBIB
- National Library of Medicine
- National Center for Research Resources (AG016570, EB01651, LM05639, RR019771)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- Alzheimer's disease, mild cognitive impairment, normal aging, diffusion tensor imaging, fractional anisotropy, white matter diffusivity, white matter microstructure, temporal lobe, neurodegeneration biomarkers, cognitive impairment detection, voxel-based analysis, region of interest analysis
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