Alzheimer's Imaging Consortium.

Area of Science:

• Neurology
• Neuroimaging
• Alzheimer's Disease Research

Background:

• Prognostic risk stratification is crucial for early-onset Alzheimer's disease (EOAD) patients at the mild cognitive impairment (MCI) stage.
• The prognostic value of MRI-based brain structure measures for predicting dementia progression in EOAD is unclear.
• Existing research primarily focuses on late-onset Alzheimer's disease.

Purpose of the Study:

• To evaluate the utility of cortical atrophy within the EOAD signature as a predictor of time to dementia progression.
• To examine the independent and synergistic contributions of EOAD signature atrophy and clinical severity measures.

Main Methods:

• Measured cortical atrophy (W-scores) in EOAD signature regions in 130 MCI-stage EOAD patients.
• Quantified baseline clinical severity using Clinical Dementia Rating Sum-of-Boxes (CDR-SB) scores.
• Employed Cox regression models to analyze the relationship between atrophy, CDR-SB, and dementia progression.

Main Results:

• Greater baseline atrophy in the EOAD signature significantly predicted a higher risk of progression to dementia (HR=1.2).
• The EOAD MRI signature provided additive value to CDR-SB in predicting progression (HR=2.1).

Conclusions:

• The EOAD MRI signature serves as a valuable imaging biomarker for prognostication in EOAD.
• Findings can guide clinical trial design and inform patient/family decision-making.
• Supports the use of neuroimaging in predicting Alzheimer's disease progression.