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. 2018 Jan;14(1):43-53.
doi: 10.1016/j.jalz.2017.06.2268. Epub 2017 Jul 22.

Presymptomatic atrophy in autosomal dominant Alzheimer's disease: A serial magnetic resonance imaging study

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Presymptomatic atrophy in autosomal dominant Alzheimer's disease: A serial magnetic resonance imaging study

Kirsi M Kinnunen et al. Alzheimers Dement. 2018 Jan.

Abstract

Introduction: Identifying at what point atrophy rates first change in Alzheimer's disease is important for informing design of presymptomatic trials. VSports手机版.

Methods: Serial T1-weighted magnetic resonance imaging scans of 94 participants (28 noncarriers, 66 carriers) from the Dominantly Inherited Alzheimer Network were used to measure brain, ventricular, and hippocampal atrophy rates. For each structure, nonlinear mixed-effects models estimated the change-points when atrophy rates deviate from normal and the rates of change before and after this point V体育安卓版. .

Results: Atrophy increased after the change-point, which occurred 1-1. 5 years (assuming a single step change in atrophy rate) or 3-8 years (assuming gradual acceleration of atrophy) before expected symptom onset V体育ios版. At expected symptom onset, estimated atrophy rates were at least 3. 6 times than those before the change-point. .

Discussion: Atrophy rates are pathologically increased up to seven years before "expected onset". During this period, atrophy rates may be useful for inclusion and tracking of disease progression. VSports最新版本.

Keywords: Alzheimer's disease; Atrophy; Autosomal dominant; Boundary Shift Integral; Change-point; Dementia; Longitudinal; MRI; Neuroimaging; Nonlinear modeling V体育平台登录. .

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Fig. 1
Fig. 1
Schematic representation of the “step change” (A) and “gradual acceleration” (B) change-point models.
Fig. 2
Fig. 2
Rates of change estimated from the “step change” and “gradual acceleration” models, as a function of the estimated years from symptom onset (EYO) for the pMut+/qMut+ carriers. The figure shows the relationship between rate of annualized volume change (%) and EYO. 95% confidence intervals are included, computed from the bootstrap samples. Although the schematics in Fig. 1 display the decline in actual volume, these graphs represent the rate of change in volume. A horizontal line indicates the estimated atrophy rate (from the “step change” model) for noncarriers and carriers before the change-point before any deviation from normal rates of change. Vertical dotted lines indicate the change-points for both the “step change” and “gradual acceleration” models. For periods that include the change-point, the estimated rate of atrophy is a weighted combination, representing the transition from the pre-change-point atrophy to the post-change-point atrophy. Top left: whole brain; top right: lateral ventricles; bottom left: left hippocampus; bottom right: right hippocampus.

References

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