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Tract-based spatial statistics: application to mild cognitive impairment
Yau-Yau Wai1, Wen-Chuin Hsu2, Hon-Chung Fung3
1Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan County, Taiwan ; Department of Radiology and Intervention, Chang Gung Memorial Hospital, 5 FuHsing Street, Linkou, Taoyuan County, Taiwan.
Rationale And Objectives:
The primary objective of the current investigation was to characterize white matter integrity in different subtypes of mild cognitive impairment (MCI) using tract-based spatial statistics of diffusion tensor imaging.
Materials And Methods:
The study participants were divided into 4 groups of 30 subjects each as follows: cognitively healthy controls, amnestic MCI, dysexecutive MCI, and Alzheimer's disease (AD). All subjects underwent a comprehensive neuropsychological assessment, apolipoprotein E genotyping, and 3-tesla MRI. The diffusion tensor was reconstructed and then analyzed using tract-based spatial statistics. The changes in brain white matter tracts were also examined according to the apolipoprotein E ε 4 status.
Results:
Compared with controls, amnestic MCI patients showed significant differences in the cerebral white matter, where changes were consistently detectable in the frontal and parietal lobes. We found a moderate impact of the apolipoprotein E ε 4 status on the extent of white matter disruption in the amnestic MCI group. Patients with AD exhibited similar but more extensive alterations, while no significant changes were observed in dysexecutive MCI patients.
Conclusion:
The results from this study indicate that amnestic MCI is the most likely precursor to AD as both conditions share significant white matter damage. By contrast, dysexecutive MCI seems to be characterized by a distinct pathogenesis.
Insights
Amnestic mild cognitive impairment (MCI) shows white matter damage similar to Alzheimer's disease (AD), suggesting it may be a precursor. Dysexecutive MCI appears to have a different underlying cause.
Area of Science:
- Neuroimaging
- Neurology
- Biomarkers
Background:
- Mild cognitive impairment (MCI) is a heterogeneous condition.
- Distinguishing MCI subtypes is crucial for understanding disease progression and developing targeted treatments.
- White matter integrity is increasingly recognized as a key indicator in neurodegenerative diseases.
Purpose of the Study:
- To investigate and compare white matter integrity across different subtypes of mild cognitive impairment (MCI) and Alzheimer's disease (AD).
- To utilize diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS) for detailed white matter analysis.
- To explore the influence of apolipoprotein E (ApoE) ε 4 status on white matter changes in MCI.
Main Methods:
- Diffusion tensor imaging (DTI) analysis using tract-based spatial statistics (TBSS) on 3-tesla MRI scans.
- Participants were categorized into four groups: cognitively healthy controls, amnestic MCI, dysexecutive MCI, and Alzheimer's disease (AD), with 30 subjects per group.
- Neuropsychological assessments and apolipoprotein E genotyping were performed on all participants.
Main Results:
- Amnestic MCI patients exhibited significant white matter differences in frontal and parietal lobes compared to controls.
- Alzheimer's disease (AD) patients showed more extensive white matter alterations than amnestic MCI.
- Dysexecutive MCI patients did not display significant white matter changes, suggesting a distinct pathological pathway.
Conclusions:
- Amnestic MCI is strongly associated with white matter damage similar to AD, indicating its potential role as a precursor.
- Dysexecutive MCI appears to have a separate pathogenesis, distinct from amnestic MCI and AD.
- White matter integrity analysis via DTI-TBSS can differentiate MCI subtypes and their relationship to AD.
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