The anteroposterior and primary-to-posterior limbic ratios as MRI-derived volumetric markers of Alzheimer's disease

Adolfo Jiménez-Huete; Susana Estévez-Santé

doi:10.1016/j.jns.2017.04.046

Research Article| Volume 378, P110-119, July 15, 2017

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The anteroposterior and primary-to-posterior limbic ratios as MRI-derived volumetric markers of Alzheimer's disease

Adolfo Jiménez-Huete
Adolfo Jiménez-Huete
Correspondence
Corresponding author.
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Affiliations
Department of Neurology, Hospital Ruber Internacional, C/La Masó, 38, 28034 Madrid, Spain
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Susana Estévez-Santé
Susana Estévez-Santé
Affiliations
Department of Neurology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
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for the ADNI group
¹
Author Footnotes
1 Data used in preparation of this article were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database (adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at: http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf.
Show footnotesHide footnotes
Author Footnotes
1 Data used in preparation of this article were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database (adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at: http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf.

Published:April 27, 2017DOI:https://doi.org/10.1016/j.jns.2017.04.046

Highlights

•
gm_extractor is a script that allows the automated calculation of brain volumes.
•
Two volume ratios were designed to detect the pattern of atrophy associated with AD.
•
These ratios were useful to differentiate normal from cognitively impaired subjects.

Abstract

Background/aims

Alzheimer's disease (AD) shows a characteristic pattern of brain atrophy, with predominant involvement of posterior limbic structures, and relative preservation of rostral limbic and primary cortical regions. We aimed to investigate the diagnostic utility of two gray matter volume ratios based on this pattern, and to develop a fully automated method to calculate them from unprocessed MRI files.

Patients and methods

Cross-sectional study of 118 subjects from the ADNI database, including normal controls and patients with mild cognitive impairment (MCI) and AD. Clinical variables and 3 T T1-weighted MRI files were analyzed. Regional gray matter and total intracranial volumes were calculated with a shell script (gm_extractor) based on FSL. Anteroposterior and primary-to-posterior limbic ratios (APL and PPL) were calculated from these values. Diagnostic utility of variables was tested in logistic regression models using Bayesian model averaging for variable selection. External validity was evaluated with bootstrap sampling and a test set of 60 subjects.

Results

gm_extractor showed high test-retest reliability and high concurrent validity with FSL's FIRST. Volumetric measurements agreed with the expected anatomical pattern associated with AD. APL and PPL ratios were significantly different between groups, and were selected instead of hippocampal and entorhinal volumes to differentiate normal from MCI or cognitively impaired (MCI plus AD) subjects.

Conclusion

APL and PPL ratios may be useful components of models aimed to differentiate normal subjects from patients with MCI or AD. These values, and other gray matter volumes, may be reliably calculated with gm_extractor.

Keywords

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Published online: April 27, 2017

Accepted: April 26, 2017

Received in revised form: April 17, 2017

Received: January 25, 2017

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DOI: https://doi.org/10.1016/j.jns.2017.04.046

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The anteroposterior and primary-to-posterior limbic ratios as MRI-derived volumetric markers of Alzheimer's disease

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