Using eZIS to Predict Progression from MCI to Dementia in Three Years

Area of Science:

• Neurology
• Radiology
• Geriatrics

Background:

• Mild cognitive impairment (MCI) presents a varied prognosis, with some cases progressing to dementia (Alzheimer's disease - AD) while others remain stable or improve.
• Accurate differentiation between progressive and non-progressive MCI is essential for effective patient management and therapeutic strategies.
• Identifying reliable biomarkers for predicting MCI progression is a significant clinical challenge.

Purpose of the Study:

• To evaluate the predictive utility of easy Z-score imaging system (eZIS) indicators in distinguishing progressive MCI from stable MCI.
• To assess the correlation between eZIS indicators, cognitive decline, and conversion to dementia over a three-year follow-up period.

Main Methods:

• Retrospective study involving individuals diagnosed with MCI at a university hospital.
• Collection of demographic data, comorbidities, cognitive test scores, and neuroimaging metrics including eZIS (severity, extent, ratio), Fazekas scale, and mesial temporal atrophy (MTA) scores.
• Analysis of clinical outcomes, including cognitive deterioration and conversion to dementia, using regression and ROC curve analysis.

Main Results:

• All three eZIS indicators (severity, extent, ratio) were significantly elevated in patients with progressive MCI compared to stable MCI.
• eZIS severity demonstrated a positive correlation with cognitive decline (Cognitive Abilities Screening Instrument, Clinical Dementia Rating Sum of Box scores) and conversion to dementia.
• The area under the curve (AUC) for eZIS severity was 0.719, with an optimal cutoff value of 1.22 for predicting conversion to dementia.

Conclusions:

• Increased eZIS severity is a significant predictor of worse cognitive function and a higher likelihood of conversion from MCI to dementia within three years.
• eZIS imaging offers a valuable tool for identifying individuals with MCI at higher risk of progressing to Alzheimer's disease dementia.
• These findings support the use of eZIS severity as a prognostic biomarker in MCI management.