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P2‐424: White matter differences between healthy young APOE‐ε4 carriers and noncarriers identified with tractographic and support vector machine methods
Author(s) -
O'Dwyer Laurence,
Lamberton Franck,
Matura Silke,
Tanner Colby,
Scheibe Monika,
Miller Julia,
Rujescu Dan,
Prvulovic David,
Hampel Harald
Publication year - 2012
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2012.05.2049
Subject(s) - grey matter , white matter , putamen , apolipoprotein e , hippocampus , caudate nucleus , atrophy , amygdala , thalamus , hippocampal formation , population , allele , psychology , neuroscience , medicine , biology , disease , genetics , gene , magnetic resonance imaging , environmental health , radiology
(AD) will present an opportunity to improve patient outcomes. Using clinical measurements of disease progression to supplement assessments of cognition and memory may provide evidence of disease progression and/or treatment. Ongoing research involving the use of volumetric magnetic resonance imaging (vMRI) of the whole brain in subjects with mild-to-moderate AD (MtM-AD) provides a promising objective outcome measure for monitoring disease progression and effects of treatment. Methods: A systematic review of the literature evaluated vMRI in subjects with MtM-AD to track the longitudinal loss of volume during disease progression. Studies published in English between January 1995 and October 2010 reporting whole-brain volume loss in subjects with MtM-AD were included in a meta-analysis. Using random-effects modeling, two sets of meta-analyses were conducted. The first compared annualized whole-brain atrophy rates for subjects with MtM-AD and healthy controls; the second compared differences in whole-brain atrophy rates between subjects with MtM-AD and healthy controls.Results:Of 1164 citations, final screening yielded 24 studies examining vMRI of the whole brain in subjects with MtM-AD. Nineteen of the 24 studies had data suitable for the meta-analysis of whole-brain atrophy. Follow-up ranged from 1 to 2 years. Among controls, annual loss in whole-brain volume ranged from -0.9 to +1.1%. Only one study reported a slight volume increase (1.1%) in control subjects. The pooled meta-analytic estimate of whole-brain atrophy in healthy controls was -0.44% (95% CI: -0.57, 0.30). Among subjects with MtM-AD, annual whole-brain atrophy ranged from -0.98% to -5.22%. The overall estimate of annual whole-brain loss across studies for subjects with MtM-AD was -2.12% (95% CI: -2.51, -1.73). When whole-brain atrophy was compared between subjects with MtM-AD and controls, results showed a significantly higher rate of brain-volume loss in MtM-AD: mean difference of -1.76% (95% CI: -2.28, -1.24). Baseline AD severity, measured by MMSE score, was a significant factor: higher severity reflected greater atrophy. Conclusions: Brain atrophy-as measured by volume loss-was significantly greater in subjects with MtM-AD, especially as the disease progressed. Annualized whole-brain atrophy rates in subjects with MtM-AD were approximately 1.75% greater than in control subjects.