Detecting frontotemporal dementia syndromes using MRI biomarkers
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Detecting frontotemporal dementia syndromes using MRI biomarkers. / Bruun, Marie; Koikkalainen, Juha; Rhodius-Meester, Hanneke F.M.; Baroni, Marta; Gjerum, Le; van Gils, Mark; Soininen, Hilkka; Remes, Anne M.; Hartikainen, Päivi; Waldemar, Gunhild; Mecocci, Patrizia; Barkhof, Frederik; Pijnenburg, Yolande; van der Flier, Wiesje M.; Hasselbalch, Steen G.; Lötjönen, Jyrki; Frederiksen, Kristian S.
In: NeuroImage: Clinical, Vol. 22, 101711, 2019.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Detecting frontotemporal dementia syndromes using MRI biomarkers
AU - Bruun, Marie
AU - Koikkalainen, Juha
AU - Rhodius-Meester, Hanneke F.M.
AU - Baroni, Marta
AU - Gjerum, Le
AU - van Gils, Mark
AU - Soininen, Hilkka
AU - Remes, Anne M.
AU - Hartikainen, Päivi
AU - Waldemar, Gunhild
AU - Mecocci, Patrizia
AU - Barkhof, Frederik
AU - Pijnenburg, Yolande
AU - van der Flier, Wiesje M.
AU - Hasselbalch, Steen G.
AU - Lötjönen, Jyrki
AU - Frederiksen, Kristian S.
PY - 2019
Y1 - 2019
N2 - Background: Diagnosing frontotemporal dementia may be challenging. New methods for analysis of regional brain atrophy patterns on magnetic resonance imaging (MRI) could add to the diagnostic assessment. Therefore, we aimed to develop automated imaging biomarkers for differentiating frontotemporal dementia subtypes from other diagnostic groups, and from one another. Methods: In this retrospective multicenter cohort study, we included 1213 patients (age 67 ± 9, 48% females) from two memory clinic cohorts: 116 frontotemporal dementia, 341 Alzheimer's disease, 66 Dementia with Lewy bodies, 40 vascular dementia, 104 other dementias, 229 mild cognitive impairment, and 317 subjective cognitive decline. Three MRI atrophy biomarkers were derived from the normalized volumes of automatically segmented cortical regions: 1) the anterior vs. posterior index, 2) the asymmetry index, and 3) the temporal pole left index. We used the following performance metrics: area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. To account for the low prevalence of frontotemporal dementia we pursued a high specificity of 95%. Cross-validation was used in assessing the performance. The generalizability was assessed in an independent cohort (n = 200). Results: The anterior vs. posterior index performed with an AUC of 83% for differentiation of frontotemporal dementia from all other diagnostic groups (Sensitivity = 59%, Specificity = 95%, positive likelihood ratio = 11.8, negative likelihood ratio = 0.4). The asymmetry index showed highest performance for separation of primary progressive aphasia and behavioral variant frontotemporal dementia (AUC = 85%, Sensitivity = 79%, Specificity = 92%, positive likelihood ratio = 9.9, negative likelihood ratio = 0.2), whereas the temporal pole left index was specific for detection of semantic variant primary progressive aphasia (AUC = 85%, Sensitivity = 82%, Specificity = 80%, positive likelihood ratio = 4.1, negative likelihood ratio = 0.2). The validation cohort provided corresponding results for the anterior vs. posterior index and temporal pole left index. Conclusion: This study presents three quantitative MRI biomarkers, which could provide additional information to the diagnostic assessment and assist clinicians in diagnosing frontotemporal dementia.
AB - Background: Diagnosing frontotemporal dementia may be challenging. New methods for analysis of regional brain atrophy patterns on magnetic resonance imaging (MRI) could add to the diagnostic assessment. Therefore, we aimed to develop automated imaging biomarkers for differentiating frontotemporal dementia subtypes from other diagnostic groups, and from one another. Methods: In this retrospective multicenter cohort study, we included 1213 patients (age 67 ± 9, 48% females) from two memory clinic cohorts: 116 frontotemporal dementia, 341 Alzheimer's disease, 66 Dementia with Lewy bodies, 40 vascular dementia, 104 other dementias, 229 mild cognitive impairment, and 317 subjective cognitive decline. Three MRI atrophy biomarkers were derived from the normalized volumes of automatically segmented cortical regions: 1) the anterior vs. posterior index, 2) the asymmetry index, and 3) the temporal pole left index. We used the following performance metrics: area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. To account for the low prevalence of frontotemporal dementia we pursued a high specificity of 95%. Cross-validation was used in assessing the performance. The generalizability was assessed in an independent cohort (n = 200). Results: The anterior vs. posterior index performed with an AUC of 83% for differentiation of frontotemporal dementia from all other diagnostic groups (Sensitivity = 59%, Specificity = 95%, positive likelihood ratio = 11.8, negative likelihood ratio = 0.4). The asymmetry index showed highest performance for separation of primary progressive aphasia and behavioral variant frontotemporal dementia (AUC = 85%, Sensitivity = 79%, Specificity = 92%, positive likelihood ratio = 9.9, negative likelihood ratio = 0.2), whereas the temporal pole left index was specific for detection of semantic variant primary progressive aphasia (AUC = 85%, Sensitivity = 82%, Specificity = 80%, positive likelihood ratio = 4.1, negative likelihood ratio = 0.2). The validation cohort provided corresponding results for the anterior vs. posterior index and temporal pole left index. Conclusion: This study presents three quantitative MRI biomarkers, which could provide additional information to the diagnostic assessment and assist clinicians in diagnosing frontotemporal dementia.
KW - Behavioral variant frontotemporal dementia
KW - Dementia
KW - Differential diagnosis
KW - Frontotemporal lobar degeneration
KW - MRI
KW - Primary progressive aphasia
U2 - 10.1016/j.nicl.2019.101711
DO - 10.1016/j.nicl.2019.101711
M3 - Journal article
C2 - 30743135
AN - SCOPUS:85061193776
VL - 22
JO - NeuroImage: Clinical
JF - NeuroImage: Clinical
SN - 2213-1582
M1 - 101711
ER -
ID: 238433309