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Detecting Primary Progressive Aphasia Atrophy Patterns: A Comparison of Visual Assessment and Quantitative

Stephanie Franczak1, Jessica Pommy1, Greta Minor1

  • 1Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.

Journal of Alzheimer'S Disease Reports
|October 3, 2022
PubMed
Summary

Automated MRI analysis software showed low reliability and failed to distinguish logopenic variant primary progressive aphasia (lvPPA) from mild cognitive impairment. Left-sided atrophy was not reliably detected in PPA patients.

Keywords:
Logopenic variant PPAmagnetic resonance imagingmild cognitive impairmentneuroreader

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Area of Science:

  • Neuroimaging
  • Neurology
  • Artificial Intelligence in Medicine

Background:

  • Automated MRI analysis software provides z-scores for brain regions, but validation in primary progressive aphasia (PPA) is lacking.
  • Current software compares patient brain volumes to normative data, offering potential for objective atrophy assessment.

Purpose of the Study:

  • To validate Neuroreader™ z-scores in PPA by comparing them to visual MRI assessments.
  • To determine if Neuroreader™ can detect left > right atrophy in cortical regions specific to logopenic variant PPA (lvPPA).
  • To assess Neuroreader™'s ability to differentiate lvPPA from amnestic mild cognitive impairment (aMCI).

Main Methods:

  • Included patients with lvPPA (n=11) or aMCI (n=12) who underwent MRI with Neuroreader™.
  • Two neuroradiologists visually rated atrophy in 10 brain regions.
  • Analyzed Neuroreader™ lobar z-scores and hippocampal asymmetry metrics.

Main Results:

  • Interrater reliability (Cohen's Kappa) was moderate to low (k=0.351 to 0.593) for visual MRI ratings.
  • Neuroradiologists achieved 0% agreement on the presence of left-sided asymmetry.
  • Neuroreader™ did not significantly differentiate lvPPA from aMCI in frontal, temporal, or parietal regions.
  • lvPPA showed significantly lower left-sided z-scores in the hippocampus, parietal, occipital, and temporal cortices compared to the right.

Conclusions:

  • Neuroreader™ demonstrated moderate to low interrater reliability and failed to reliably detect left-sided atrophy.
  • The software could not distinguish between lvPPA and aMCI.
  • Further validation and refinement of automated MRI analysis tools are needed for PPA.