Structural MRI Biomarkers Related to Cognitive Recovery and Resistance to Recovery Using the Penalized Mixture Cure...

Area of Science:

• Neuroimaging
• Neurology
• Biostatistics

Background:

• Cognitive trajectories in individuals with a baseline Clinical Dementia Rating (CDR) score of 0.5 exhibit significant variability, ranging from recovery to resistance.
• Identifying predictors of these diverse trajectories is crucial for developing targeted interventions for cognitive decline.

Purpose of the Study:

• To investigate baseline structural magnetic resonance imaging (MRI) features and clinical factors associated with recovery rates and resistance in individuals with CDR 0.5.
• To utilize a penalized mixture cure model (MCM) to analyze these associations.

Main Methods:

• Analysis of data from 185 individuals with a baseline CDR of 0.5 from the OASIS-3 database.
• Assessment of structural MRI features and clinical measures using latency (recovery rate) and incidence (resistance) components of an MCM.

Main Results:

• Right rostral middle frontal thickness predicted faster recovery (HR=2.06), while right frontal pole thickness predicted slower recovery (HR=0.48).
• Left bankssts volume predicted resistance (OR=2.21), and left pars orbitalis thickness was protective (OR=0.56).
• Right supramarginal thickness showed paradoxical associations with both faster recovery (HR=1.24) and increased resistance (OR=1.48).

Conclusions:

• Mixture cure models reveal complex, context-dependent roles of structural MRI features in cognitive recovery and resistance.
• Frontal and temporal lobe structures are pivotal in determining cognitive outcomes.
• Findings support the use of MCM for personalized therapeutic strategies and understanding recovery dynamics in cognitive impairment.