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Visual ratings of atrophy in MCI: prediction of conversion and relationship with CSF biomarkers
Manja Lehmann1, Esther L Koedam, Josephine Barnes
1Dementia Research Centre, UCL Institute of Neurology, London, UK. m.lehmann@ucl.ac.uk
Abstract:
Medial temporal lobe atrophy (MTA) and cerebrospinal fluid (CSF) markers of Alzheimer's disease (AD) pathology may aid the early detection of AD in mild cognitive impairment (MCI). However, the relationship between structural and pathological markers is not well understood. Furthermore, while posterior atrophy (PA) is well recognized in AD, its value in predicting conversion from late-onset amnestic MCI to AD is unclear. In this study we used visual ratings of MTA and PA to assess their value in predicting conversion to AD in 394 MCI patients. The relationship of atrophy patterns with CSF Aβ1-42, tau, and p-tau(181) was further investigated in 114 controls, 192 MCI, and 99 AD patients. There was a strong association of MTA ratings with conversion to AD (p < 0.001), with a weaker association for PA ratings (p = 0.047). Specific associations between visual ratings and CSF biomarkers were found; MTA was associated with lower levels of Aβ1-42 in MCI, while PA was associated with elevated levels of tau in MCI and AD, which may reflect widespread neuronal loss including posterior regions. These findings suggest both that posterior atrophy may predict conversion to AD in late-onset MCI, and that there may be differential relationships between CSF biomarkers and regional atrophy patterns.
Insights
Medial temporal lobe atrophy (MTA) strongly predicts Alzheimer's disease (AD) conversion in mild cognitive impairment (MCI). Posterior atrophy (PA) also shows predictive value, with distinct relationships between atrophy patterns and cerebrospinal fluid (CSF) biomarkers.
Area of Science:
- Neuroimaging
- Biomarkers
- Neurodegenerative Diseases
Background:
- Medial temporal lobe atrophy (MTA) and cerebrospinal fluid (CSF) markers are potential early indicators of Alzheimer's disease (AD) in mild cognitive impairment (MCI).
- The interplay between structural brain changes (atrophy) and AD pathology markers (CSF) requires further elucidation.
- The predictive value of posterior atrophy (PA) for AD conversion in late-onset amnestic MCI is not well-established.
Purpose of the Study:
- To evaluate the predictive value of visual ratings of MTA and PA for conversion to AD in MCI patients.
- To investigate the associations between regional atrophy patterns (MTA, PA) and CSF biomarkers (Aβ1-42, tau, p-tau(181)) in controls, MCI, and AD patients.
Main Methods:
- Visual rating scales were used to assess MTA and PA in 394 MCI patients.
- CSF levels of Aβ1-42, tau, and p-tau(181) were analyzed in 114 controls, 192 MCI, and 99 AD patients.
- Statistical analyses were performed to determine the association between atrophy ratings, CSF biomarkers, and conversion to AD.
Main Results:
- MTA ratings showed a strong association with conversion to AD (p < 0.001).
- PA ratings demonstrated a weaker but significant association with AD conversion (p = 0.047).
- MTA correlated with lower CSF Aβ1-42 in MCI, while PA correlated with elevated CSF tau in MCI and AD, suggesting differential relationships.
Conclusions:
- Both MTA and PA are valuable predictors of AD conversion in late-onset MCI.
- Differential associations exist between CSF biomarkers and regional atrophy patterns, potentially reflecting distinct pathological processes.
- These findings enhance our understanding of the relationship between structural changes and AD pathology, aiding early detection and diagnosis.
