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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Prediction of deterioration of mild cognitive impairment with CT and SPECT
Tomasz Gabryelewicz1, Agnieszka Pawłowska-Detko, Jolanta Miśko
1Department of Neurodegenerative Disorders, Medical Research Center, Polish Academy of Sciences, Warsaw, Poland. gabryelewicz@cmdik.pan.pl <gabryelewicz@cmdik.pan.pl>
Background:
Mild cognitive impairment (MCI) is a condition referring to persons with significant memory impairment, often accompanied by functional deficits in the attention, language, visuospatial, and psychomotor domains, who do not fulfill the criteria for dementia. Individuals with MCI are at an increased risk of developing dementia. The objective of this study was to examine baseline differences between MCI subjects who did or did not deteriorate at follow-up on measures of cognition and neuroimaging.
Material/Methods:
MCI individuals (n=105) enrolled in a longitudinal study at the Alzheimer's Day Clinic in Warsaw received annual clinical and psychometric examinations for up to a mean of three years. At baseline, all patients received temporal lobe-oriented CT and 99mTc HMPAO SPECT. The diagnosis of MCI according to Mayo Clinic Petersen's Criteria was conducted by a panel of specialists and neuropsychological testing was completed on all subjects.
Results:
After three years of follow-up, 42 subjects remained stable or had improved (8) and 63 had progressive cognitive disturbances, including 23 who converted to dementia. Compared with stable MCI patients, decliners have significantly higher radial width of the temporal horn bilaterally and width of the lateral part of the transverse fissure on the right, dilated third ventricle, and smaller oblique thickness of the anterior part of the hippocampal formation bilaterally at the baseline. No significant differences in SPECT perfusion were found between the two groups.
Conclusions:
The proposed linear measurements of atrophy in CT may constitute a predictor for those MCI patients who are more likely to deteriorate.
Insights
Mild cognitive impairment (MCI) patients with specific brain structure changes at baseline are more likely to progress. These CT-based measurements may predict cognitive decline in MCI individuals.
Area of Science:
- Neurology
- Neuroimaging
- Cognitive Science
Background:
- Mild cognitive impairment (MCI) involves memory deficits and functional impairments, increasing dementia risk.
- Distinguishing MCI patients who will progress from those who remain stable is crucial for early intervention.
- This study investigated baseline neuroimaging and cognitive differences in MCI subjects based on their progression over time.
Purpose of the Study:
- To identify baseline neuroimaging and cognitive predictors of cognitive deterioration in individuals with MCI.
- To compare neuroimaging markers between MCI patients who remained stable and those who progressed over a three-year follow-up period.
Main Methods:
- 105 individuals diagnosed with MCI underwent annual clinical and psychometric evaluations for up to three years.
- Baseline neuroimaging included temporal lobe-oriented CT scans and 99mTc HMPAO SPECT.
- MCI diagnosis followed Mayo Clinic Petersen's Criteria, with comprehensive neuropsychological testing.
Main Results:
- Of 105 MCI subjects, 63 showed cognitive decline, with 23 converting to dementia within three years.
- Progressing MCI patients exhibited significantly greater temporal horn width, wider right transverse fissure, a dilated third ventricle, and thinner hippocampi at baseline compared to stable patients.
- No significant differences in brain perfusion (SPECT) were observed between the groups.
Conclusions:
- Linear measurements of brain atrophy on CT scans at baseline can predict which MCI patients are more likely to deteriorate.
- CT-based morphometric analysis offers a potential tool for identifying MCI individuals at higher risk for progression to dementia.
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