Dataset Information

Can T1-Weighted Magnetic Resonance Imaging Significantly Improve Mini-Mental State Examination-Based Distinguishing Between Mild Cognitive Impairment and Early-Stage Alzheimer's Disease?

ABSTRACT:

Background

Detecting early-stage Alzheimer's disease (AD) is still problematic in clinical practice. This work aimed to find T1-weighted MRI-based markers for AD and mild cognitive impairment (MCI) to improve the screening process.

Objective

Our assumption was to build a screening model that would be accessible and easy to use for physicians in their daily clinical routine.

Methods

The multinomial logistic regression was used to detect status: AD, MCI, and normal control (NC) combined with the Bayesian information criterion for model selection. Several T1-weighted MRI-based radiomic features were considered explanatory variables in the prediction model.

Results

The best radiomic predictor was the relative brain volume. The proposed method confirmed its quality by achieving a balanced accuracy of 95.18%, AUC of 93.25%, NPV of 97.93%, and PPV of 90.48% for classifying AD versus NC for the European DTI Study on Dementia (EDSD). The comparison of the two models: with the MMSE score only as an independent variable and corrected for the relative brain value and age, shows that the addition of the T1-weighted MRI-based biomarker improves the quality of MCI detection (AUC: 67.04% versus 71.08%) while maintaining quality for AD (AUC: 93.35% versus 93.25%). Additionally, among MCI patients predicted as AD inconsistently with the original diagnosis, 60% from ADNI and 76.47% from EDSD were re-diagnosed as AD within a 48-month follow-up. It shows that our model can detect AD patients a few years earlier than a standard medical diagnosis.

Conclusion

The created method is non-invasive, inexpensive, clinically accessible, and efficiently supports AD/MCI screening.

SUBMITTER: Marcisz A

PROVIDER: S-EPMC10116132 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Can T1-Weighted Magnetic Resonance Imaging Significantly Improve Mini-Mental State Examination-Based Distinguishing Between Mild Cognitive Impairment and Early-Stage Alzheimer's Disease?

Marcisz Anna A Polanska Joanna J

Journal of Alzheimer's disease : JAD 20230101 3

<h4>Background</h4>Detecting early-stage Alzheimer's disease (AD) is still problematic in clinical practice. This work aimed to find T1-weighted MRI-based markers for AD and mild cognitive impairment (MCI) to improve the screening process.<h4>Objective</h4>Our assumption was to build a screening model that would be accessible and easy to use for physicians in their daily clinical routine.<h4>Methods</h4>The multinomial logistic regression was used to detect status: AD, MCI, and normal control (N ...[more]

PMID: 36806505

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Project description:BackgroundDisease-modifying treatments for Alzheimer's disease highlight the need for early detection of cognitive decline. However, at present, most primary care providers do not perform routine cognitive testing, in part due to a lack of access to practical cognitive assessments, as well as time and resources to administer and interpret the tests. Brief and sensitive digital cognitive assessments, such as the Digital Clock and Recall (DCR™), have the potential to address this need. Here, we examine the advantages of DCR over the Mini-Mental State Examination (MMSE) in detecting mild cognitive impairment (MCI) and mild dementia.MethodsWe studied 706 participants from the multisite Bio-Hermes study (age mean ± SD = 71.5 ± 6.7; 58.9% female; years of education mean ± SD = 15.4 ± 2.7; primary language English), classified as cognitively unimpaired (CU; n = 360), mild cognitive impairment (MCI; n = 234), or probable mild Alzheimer's dementia (pAD; n = 111) based on a review of medical history with selected cognitive and imaging tests. We evaluated cognitive classifications (MCI and early dementia) based on the DCR and the MMSE against cohorts based on the results of the Rey Auditory Verbal Learning Test (RAVLT), the Trail Making Test-Part B (TMT-B), and the Functional Activities Questionnaire (FAQ). We also compared the influence of demographic variables such as race (White vs. Non-White), ethnicity (Hispanic vs. Non-Hispanic), and level of education (≥ 15 years vs. < 15 years) on the DCR and MMSE scores.ResultsThe DCR was superior on average to the MMSE in classifying mild cognitive impairment and early dementia, AUC = 0.70 for the DCR vs. 0.63 for the MMSE. DCR administration was also significantly faster (completed in less than 3 min regardless of cognitive status and age). Among 104 individuals who were labeled as "cognitively unimpaired" by the MMSE (score ≥ 28) but actually had verbal memory impairment as confirmed by the RAVLT, the DCR identified 84 (80.7%) as impaired. Moreover, the DCR score was significantly less biased by ethnicity than the MMSE, with no significant difference in the DCR score between Hispanic and non-Hispanic individuals.ConclusionsDCR outperforms the MMSE in detecting and classifying cognitive impairment-in a fraction of the time-while being not influenced by a patient's ethnicity. The results support the utility of DCR as a sensitive and efficient cognitive assessment in primary care settings.Trial registrationClinicalTrials.gov identifier NCT04733989.

Project description:BackgroundAnal fistula is a common anorectal disorder that significantly diminishes the quality of life for affected patients. Accurate preoperative evaluation of the fistula's traits is essential for customizing surgical strategies, improving patient outcomes, and reducing the likelihood of the disease returning. This study aimed to evaluate the diagnostic accuracy of multi-phase contrast-enhanced fat-suppressed T1-weighted imaging using three-dimensional gradient echo sequence volumetric interpolated breath-hold examination (CE-FS-T1-3D-VIBE) and fat-suppressed T2-weighted imaging combined with diffusion-weighted imaging (FS-T2WI-DWI) sequence in delineating the characteristics of anal fistulas.MethodsA case-control study of 168 patients with anal fistula was conducted through the picture archiving and communication systems (PACS; diagnostic imaging workstation). Imaging evaluations were performed using both multi-phase CE-FS-T1-3D-VIBE and FS-T2WI-DWI imaging on a Siemens 3.0T magnetic resonance imaging system (Skyra 3.0T superconducting type). The efficacy of each imaging modality in depicting the clarity, number, and positioning of the internal openings, as well as the identification of primary and secondary fistulas and abscesses, was independently evaluated in a blinded manner by two senior diagnostic radiologists, each with over a decade of experience. Statistical analyses were performed using χ2 test.ResultsComparative analysis of the FS-T2WI-DWI and multi-phase CE-FS-T1-3D-VIBE sequences for diagnosing internal and primary fistula tract clarity demonstrated a significant superiority of the multi-phase CE-FS-T1-3D-VIBE sequence in delineating internal clarity (P=0.013) and primary fistula tract clarity (P<0.001). The multi-phase CE-FS-T1-3D-VIBE sequence demonstrated superior accuracy over the FS-T2WI-DWI sequence in depicting localization of internal openings [86.31% vs. 77.38%, 95% confidence interval (CI): 0.307-0.959, P=0.034], as well as delineation of the secondary tracts (88.69% vs. 80.95%, 95% CI: 0.293-1.001, P=0.048). Despite the increased accuracy of the multi-phase CE-FS-T1-3D-VIBE sequence, no difference was observed between the two imaging techniques regarding the accuracy in determining the number of internal openings, the quantity of primary fistulas, and the classification of anal fistulas.ConclusionsThis study elucidates that the multi-phase CE-FS-T1-3D-VIBE imaging sequence potentially represents a more effective noninvasive alternative for the precise evaluation of the positioning and clarity of the internal opening, as well as the delineation of primary and secondary fistula tracts in anal fistula patients, compared to the FS-T2WI-DWI sequence. This enhanced diagnostic capability underscores the utility of multi-phase CE-FS-T1-3D-VIBE in improving the clinical management of anal fistulas.

Dataset Information

Can T1-Weighted Magnetic Resonance Imaging Significantly Improve Mini-Mental State Examination-Based Distinguishing Between Mild Cognitive Impairment and Early-Stage Alzheimer's Disease?

Background

Objective

Methods

Results

Conclusion

Publications

Can T1-Weighted Magnetic Resonance Imaging Significantly Improve Mini-Mental State Examination-Based Distinguishing Between Mild Cognitive Impairment and Early-Stage Alzheimer's Disease?

Similar Datasets

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