Predicting progression from MCI to dementia using cortical disarray measurement from diffusion MRI

Mario Torso1, Pegah Khosropanah1, Steven A Chance1

  • 1Oxford Brain Diagnostics Ltd, Oxford, UK.

Abstract

Insights

Diffusion MRI microstructural measures, like cortical diffusivity, better predict mild cognitive impairment (MCI) to dementia progression than traditional MRI measures. This aids early intervention and clinical trials for at-risk individuals.

Area of Science:

  • Neuroimaging
  • Biomarkers
  • Neurodegeneration

Background:

  • Mild cognitive impairment (MCI) is a precursor to dementia.
  • Accurate prediction of MCI to dementia progression is crucial for clinical practice and trials.
  • Current predictive markers often rely on macrostructural MRI measures.

Purpose of the Study:

  • To evaluate the predictive capability of cortical microstructural measures from diffusion MRI.
  • To compare diffusion MRI microstructural measures against traditional macrostructural MRI measures for predicting dementia progression.
  • To identify individuals at high risk for dementia for earlier intervention.

Main Methods:

  • Analysis of structural and diffusion MRI scans from 826 National Alzheimer's Coordinating Center (NACC) participants.
  • Extraction of macrostructural measures (e.g., volume, thickness) and minicolumn-related diffusivity metrics (AngleR, PerpPD+, ParlPD).
  • Kaplan-Meier survival analysis to assess time to dementia conversion, stratified by biomarker metrics.

Main Results:

  • Cortical diffusivity (PerpPD+ in medial-temporal and connected regions) demonstrated superior predictive performance.
  • Diffusion MRI microstructural measures outperformed hippocampal volume, cortical volume, and cortical thickness.
  • Individuals with specific diffusivity patterns showed faster conversion to dementia.

Conclusions:

  • Cortical microstructural measures from diffusion MRI serve as powerful biomarkers for predicting MCI to dementia progression.
  • These microstructural markers offer enhanced prognostic capabilities compared to macrostructural markers.
  • Diffusion MRI biomarkers can aid in identifying and monitoring at-risk patients, improving clinical trial power and enabling earlier interventions.