Affiliations: [a] Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| [b] The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| [c]
Zhongshan City People’s Hospital, Zhongshan, Guangdong Province, China
| [d]
BrainNow Research Institute, Shenzhen, Guangdong Province, China
| [e] Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, China
| [f] Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, Shatin, China
Correspondence:
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Correspondence to: Timothy Kwok, Rm114028, 9/F., Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, N.T., Hong Kong. Tel.: +852 3505 3173; Fax: +852 2637 3852; E-mail: tkwok@cuhk.edu.hk.
Note: [1] These authors contributed equally to this work.
Abstract: Background:Structural magnetic resonance imaging markers predicting symptomatic progression at the individual level can be highly beneficial for early intervention and treatment planning for Alzheimer’s disease (AD). However, the correlation between baseline MRI findings and AD progression has not been fully established. Objective:To explore the correlation between baseline MRI findings and AD progression. Methods:Brain volumetric measures were applied to differentiate the patients at risk of fast deterioration in AD. We included 194 AD patients with a 24-month follow-up: 65 slow decliners, 63 normal decliners, and 66 fast decliners categorized by changes in Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog). ANOVA analyses were used to identify baseline brain atrophy between groups. Logistic regressions were further performed to explore the relative merits of AD resemblance structural atrophy index (AD-RAI) and individual regional volumetric measures in prediction of disease progression. Results:Atrophy in the temporal and insular lobes was associated with fast cognitive decline over 24 months. Smaller volumes of temporal and insular lobes in the left but not the right brain were associated with fast cognitive decline. Baseline AD-RAI predicted fast versus slow progression of cognitive decline (odds ratio 3.025 (95% CI: 1.064–8.600), high versus low, AUC 0.771). Moreover, AD-RAI was significantly lower among slow decliners when compared with normal decliners (p = 0.039). Conclusion:AD-RAI on MRI showed potential in identifying clinical AD patients at risk of accelerated cognitive decline.
