Brain microstructure reveals early abnormalities more than two years prior to clinical progression from mild cognitive impairment to Alzheimer's disease
Open accessAbstract
Diffusion imaging is a promising marker of microstructural damage in neurodegenerative disorders, but interpretation of its relationship with underlying neuropathology can be complex. Here, we examined both volumetric and brain microstructure abnormalities in 13 amnestic patients with mild cognitive impairment (MCI), who progressed to probable Alzheimer's disease (AD) no earlier than 2 years after baseline scanning, in order to focus on early, and hence more sensitive, imaging markers. We compared them to 22 stable amnestic MCI patients with similar cognitive performance and episodic memory impairment but who did not show progression of symptoms for at least 3 years. Significant group differences were mainly found in the volume and microstructure of the left hippocampus, while white matter group differences were also found in the body of the fornix, left fimbria, and superior longitudinal fasciculus (SLF). Diffusion index abnormalities in the SLF were the sign of a subtle microstructural injury not detected by standard atrophy measures in the corresponding gray matter regions. The microstructural measure obtained in the left hippocampus using diffusion imaging showed the most substantial differences between the two groups and was the best single predictor of future progression to AD. An optimal prediction model (91% accuracy, 85% sensitivity, 96% specificity) was obtained by combining MRI measures and CSF protein biomarkers. These results highlight the benefit of using the information of brain microstructural damage, in addition to traditional gray matter volume, to detect early, subtle abnormalities in MCI prior to clinical progression to probable AD and, in combination with CSF markers, to accurately predict such progression.
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Most studies using diffusion tensor imaging data of healthy older and Alzheimer's disease participants did not consider partial volume effects at all.
“However, most of the studies using DTI data of healthy older and AD participants did not consider PVE at all (Cherubini et al., 2010, Douaud et al., 2013, Eustache et al., 2016, Müller et al., 2007).”
From Mean diffusivity in cortical gray matter in Alzheimer's disease: The importance of partial volume correction (2018) · cites this paper as Douaud et al., 2013
In Materials and Methods (page unavailable), Douaud et al. explicitly identify partial-voluming bias as a pitfall of their grey-matter diffusion analysis and say they kept that caveat in mind. The paper therefore cannot serve as an example of a study that did not consider partial volume effects at all; it also does not establish what most other studies did. (LLM, conf=0.84)
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Experimental — accuracy not yet measuredPrevious studies reported increases of mean diffusivity in mild cognitive impairment patients that converted to Alzheimer's disease compared to mild cognitive impairment subjects that remained stable over several years.
“as well as in MCI patients that converted to AD compared to MCI subjects that remained stable over a period of several years (Douaud et al., 2013, Fellgiebel et al., 2006, Scola et al., 2010, van Uden et al., 2016).”
From Mean diffusivity in cortical gray matter in Alzheimer's disease: The importance of partial volume correction (2018) · cites this paper as Douaud et al., 2013
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- Authors
- Douaud, G., Menke, R. A. L., Gass, A., Monsch, A. U., Rao, A., Whitcher, B., Zamboni, G., Matthews, P. M., Sollberger, M., & Smith, S.
- Affiliations
- University of Oxford (GB)
- Warneford Hospital (GB)
- University Hospital of Basel (CH)
- Imperial College London (GB)
- Hammersmith Hospital (GB)
- ORCID
- Venue
- The Journal of Neuroscience
- Publisher
- Society for Neuroscience
- Published
- 2013-01-30
- Volume
- 33
- Issue
- 5
- Pages
- 2147-2155
- ISSN
- 0270-6474 (ISSN-L)
- 1529-2401
- PMC
- PMC6571077
- OpenAlex
- W2077357661
- Cited by
- 180
- References
- 16
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 10 · 2023: 11 · 2022: 10 · 2021: 7 · 2020: 18 · 2019: 19 · 2018: 14 · 2017: 18 · 2016: 17 · 2015: 16 · 2014: 20 · 2013: 8
- FWCI
- 14.46
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Neuroscience (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by-nc-sa)
- Funders
- GlaxoSmithKline
- Universität Basel
- Wellcome Trust (098369)
- National Institute for Health and Care Research
- Parkinson's UK (J-0901)
- Engineering and Physical Sciences Research Council (EP/F05727X/1)
- 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
- mild cognitive impairment, Alzheimer's disease, progression prediction, brain microstructure, diffusion imaging, hippocampus, white matter microstructure, superior longitudinal fasciculus, fornix, fimbria, cerebrospinal fluid biomarkers, neurodegeneration, episodic memory
- MeSH terms
- Aged, Alzheimer Disease, Amnesia, Atrophy, Brain, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Neuropsychological Tests, Peptide Fragments, Phosphorylation, Predictive Value of Tests, Sensitivity and Specificity, Amyloid beta-Peptides, tau Proteins, Disease Progression, Cognitive Dysfunction
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