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. 2019 Apr 1;40(5):1666-1676.
doi: 10.1002/hbm.24478. Epub 2018 Nov 19.

Discriminating Alzheimer's disease progression using a new hippocampal marker from T1-weighted MRI: The local surface roughness

Carlos Platero  1 , María Eugenia López  2 , María Del Carmen Tobar  1 , Miguel Yus  3 , Fernando Maestu  2
Affiliations

Discriminating Alzheimer's disease progression using a new hippocampal marker from T1-weighted MRI: The local surface roughness

Carlos Platero et al. Hum Brain Mapp. .

Abstract

Hippocampal atrophy is one of the main hallmarks of Alzheimer's disease (AD). However, there is still controversy about whether this sign is a robust finding during the early stages of the disease, such as in mild cognitive impairment (MCI) and subjective cognitive decline (SCD). Considering this background, we proposed a new marker for assessing hippocampal atrophy: the local surface roughness (LSR). We tested this marker in a sample of 307 subjects (normal control (NC) = 70, SCD = 87, MCI = 137, AD = 13). In addition, 97 patients with MCI were followed-up over a 3-year period and classified as stable MCI (sMCI) (n = 61) or progressive MCI (pMCI) (n = 36). We did not find significant differences using traditional markers, such as normalized hippocampal volumes (NHV), between the NC and SCD groups or between the sMCI and pMCI groups. However, with LSR we found significant differences between the sMCI and pMCI groups and a better ability to discriminate between NC and SCD. The classification accuracy of the LSR for NC and SCD was 68.2%, while NHV had a 57.2% accuracy. In addition, the classification accuracy of the LSR for sMCI and pMCI was 74.3%, and NHV had a 68.3% accuracy. Cox proportional hazards models adjusted for age, sex, and education were used to estimate the relative hazard of progression from MCI to AD based on hippocampal markers and conversion times. The LSR marker showed better prediction of conversion to AD than NHV. These results suggest the relevance of considering the LSR as a new hippocampal marker for the AD continuum.

Keywords: Alzheimer's disease continuum; hippocampal biomarkers; hippocampal segmentation; local surface roughness; progression to AD.

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Figures

Figure 1
Figure 1
The first row shows the left and right hippocampal volume distribution and the ICV using the proposed method. The second row illustrates the hippocampal markers of the progression of AD using the proposed method. LSR* indicates that this measurement is based on the thresholded map of statistical significance between the NC versus MCI groups. ICV = intracranial volume; LH = left hippocampus; RH = right hippocampus; NHV = normalized hippocampal volume; SR = surface roughness; LSR = local surface roughness; NC = normal control; SCD = subjective cognitive decline; MCI = mild cognitive impairment; AD = Alzheimer's disease
Figure 2
Figure 2
The first row shows the left and right hippocampal volume distribution and ICV for images of the sMCI and pMCI subjects. The second row illustrates the hippocampal markers (NHV = normalized hippocampal volume; SR = surface roughness; LSR = local surface roughness) in both groups. In both cases, we used the proposed method. sMCI = stable mild cognitive impairment; pMCI = progressive mild cognitive impairment
Figure 3
Figure 3
The left graph shows an ROC curve for NC versus SCD classification using the hippocampal markers (NHV = normalized hippocampal volume; SR = surface roughness; LSR = local surface roughness), and the right graph illustrates an ROC curve for sMCI versus pMCI classification using the hippocampal markers. NC = normal control; SCD = subjective cognitive decline; sMCI = stable mild cognitive impairment; pMCI = progressive mild cognitive impairment
See this image and copyright information in PMC

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