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Microstructural white matter alterations in Alzheimer's disease and amnestic mild cognitive impairment and its

Tongtong Li1, Yu Zhang1, Xiuwei Fu2

  • 1First Central Clinical College, Tianjin Medical University, Tianjin, 300192, China.

Brain Imaging and Behavior
|April 25, 2021
PubMed

Insights

Diffusion kurtosis imaging (DKI) reveals white matter microstructural changes in Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI). Kurtosis fractional anisotropy (KFA) may be a sensitive marker for detecting these alterations.

Area of Science:

  • Neuroimaging
  • Neurology
  • Biomedical Engineering

Background:

  • Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) are characterized by progressive neurodegeneration.
  • White matter microstructural integrity is crucial for cognitive function and is often compromised in neurodegenerative diseases.
  • Diffusion kurtosis imaging (DKI) offers advanced insights into white matter microstructure beyond conventional diffusion tensor imaging (DTI).

Purpose of the Study:

  • To investigate white matter microstructural alterations in AD and aMCI using DKI.
  • To compare DKI-derived parameters between AD patients, aMCI patients, and healthy controls (HC).
  • To assess the diagnostic performance of DKI parameters in differentiating between these groups and their correlation with cognitive scores.

Main Methods:

  • Prospective study involving 45 AD patients, 42 aMCI patients, and 35 HC.
  • Diffusion-weighted images acquired and analyzed using Tract-based Spatial Statistics (TBSS) with DKI.
  • Evaluated parameters: kurtosis fractional anisotropy (KFA), mean kurtosis (MK), fractional anisotropy (FA), and mean diffusivity (MD).
  • Correlations with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores analyzed.
  • Receiver operating characteristic (ROC) curve analysis performed for diagnostic evaluation.

Main Results:

  • Significant decrease in KFA observed in aMCI patients compared to HC.
  • Significant decreases in FA, KFA, and MK, and a significant increase in MD were found in AD patients compared to both HC and aMCI groups.
  • Many white matter tracts showed significant correlations between DKI parameters (FA, MD, KFA, MK) and MMSE/MoCA scores.
  • Highest diagnostic performance (Area Under the Curve - AUC) for aMCI and AD detection was achieved with KFA values in the splenium of the corpus callosum.

Conclusions:

  • White matter microstructure compactness and complexity are reduced in AD and aMCI.
  • DKI parameters, particularly KFA, show promise for detecting white matter alterations in AD and aMCI.
  • DKI can provide valuable information regarding the severity and progression of Alzheimer's disease.
Keywords:
Alzheimer’s diseaseAmnestic mild cognitive impairmentDiffusion kurtosis imagingTract-based spatial statistics

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