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MRI and CSF biomarkers in normal, MCI, and AD subjects: predicting future clinical change.
Neurology 2009; 73(4):294-301Neur

Abstract

OBJECTIVE

To investigate the relationship between baseline MRI and CSF biomarkers and subsequent change in continuous measures of cognitive and functional abilities in cognitively normal (CN) subjects and patients with amnestic mild cognitive impairment (aMCI) and Alzheimer disease (AD) and to examine the ability of these biomarkers to predict time to conversion from aMCI to AD.

METHODS

Data from the Alzheimer's Disease Neuroimaging Initiative, which consists of CN, aMCI, and AD cohorts with both CSF and MRI, were used. Baseline CSF (t-tau, Abeta(1-42), and p-tau(181P)) and MRI scans were obtained in 399 subjects (109 CN, 192 aMCI, 98 AD). Structural Abnormality Index (STAND) scores, which reflect the degree of AD-like features in MRI, were computed for each subject.

RESULTS

Change on continuous measures of cognitive and functional performance was modeled as average Clinical Dementia Rating-sum of boxes and Mini-Mental State Examination scores over a 2-year period. STAND was a better predictor of subsequent cognitive/functional change than CSF biomarkers. Single-predictor Cox proportional hazard models for time to conversion from aMCI to AD showed that STAND and log (t-tau/Abeta(1-42)) were both predictive of future conversion. The age-adjusted hazard ratio for an interquartile change (95% confidence interval) of STAND was 2.6 (1.7, 4.2) and log (t-tau/Abeta(1-42)) was 2.0 (1.1, 3.4). Both MRI and CSF provided information about future cognitive change even after adjusting for baseline cognitive performance.

CONCLUSIONS

MRI and CSF provide complimentary predictive information about time to conversion from amnestic mild cognitive impairment to Alzheimer disease and combination of the 2 provides better prediction than either source alone. However, we found that MRI was a slightly better predictor of future clinical/functional decline than the CSF biomarkers tested.

Authors+Show Affiliations

Aging and Dementia Imaging Research Laboratory, Department of Radiology, Mayo Clinic and Foundation, Rochester, MN 55905, USA.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19636049

Citation

Vemuri, P, et al. "MRI and CSF Biomarkers in Normal, MCI, and AD Subjects: Predicting Future Clinical Change." Neurology, vol. 73, no. 4, 2009, pp. 294-301.
Vemuri P, Wiste HJ, Weigand SD, et al. MRI and CSF biomarkers in normal, MCI, and AD subjects: predicting future clinical change. Neurology. 2009;73(4):294-301.
Vemuri, P., Wiste, H. J., Weigand, S. D., Shaw, L. M., Trojanowski, J. Q., Weiner, M. W., ... Jack, C. R. (2009). MRI and CSF biomarkers in normal, MCI, and AD subjects: predicting future clinical change. Neurology, 73(4), pp. 294-301. doi:10.1212/WNL.0b013e3181af79fb.
Vemuri P, et al. MRI and CSF Biomarkers in Normal, MCI, and AD Subjects: Predicting Future Clinical Change. Neurology. 2009 Jul 28;73(4):294-301. PubMed PMID: 19636049.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - MRI and CSF biomarkers in normal, MCI, and AD subjects: predicting future clinical change. AU - Vemuri,P, AU - Wiste,H J, AU - Weigand,S D, AU - Shaw,L M, AU - Trojanowski,J Q, AU - Weiner,M W, AU - Knopman,D S, AU - Petersen,R C, AU - Jack,C R,Jr AU - ,, PY - 2009/7/29/entrez PY - 2009/7/29/pubmed PY - 2009/9/10/medline SP - 294 EP - 301 JF - Neurology JO - Neurology VL - 73 IS - 4 N2 - OBJECTIVE: To investigate the relationship between baseline MRI and CSF biomarkers and subsequent change in continuous measures of cognitive and functional abilities in cognitively normal (CN) subjects and patients with amnestic mild cognitive impairment (aMCI) and Alzheimer disease (AD) and to examine the ability of these biomarkers to predict time to conversion from aMCI to AD. METHODS: Data from the Alzheimer's Disease Neuroimaging Initiative, which consists of CN, aMCI, and AD cohorts with both CSF and MRI, were used. Baseline CSF (t-tau, Abeta(1-42), and p-tau(181P)) and MRI scans were obtained in 399 subjects (109 CN, 192 aMCI, 98 AD). Structural Abnormality Index (STAND) scores, which reflect the degree of AD-like features in MRI, were computed for each subject. RESULTS: Change on continuous measures of cognitive and functional performance was modeled as average Clinical Dementia Rating-sum of boxes and Mini-Mental State Examination scores over a 2-year period. STAND was a better predictor of subsequent cognitive/functional change than CSF biomarkers. Single-predictor Cox proportional hazard models for time to conversion from aMCI to AD showed that STAND and log (t-tau/Abeta(1-42)) were both predictive of future conversion. The age-adjusted hazard ratio for an interquartile change (95% confidence interval) of STAND was 2.6 (1.7, 4.2) and log (t-tau/Abeta(1-42)) was 2.0 (1.1, 3.4). Both MRI and CSF provided information about future cognitive change even after adjusting for baseline cognitive performance. CONCLUSIONS: MRI and CSF provide complimentary predictive information about time to conversion from amnestic mild cognitive impairment to Alzheimer disease and combination of the 2 provides better prediction than either source alone. However, we found that MRI was a slightly better predictor of future clinical/functional decline than the CSF biomarkers tested. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/19636049/MRI_and_CSF_biomarkers_in_normal_MCI_and_AD_subjects:_predicting_future_clinical_change_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=19636049 DB - PRIME DP - Unbound Medicine ER -