Prediction of dementia risk from multimodal repeated measures: The added value of brain MRI biomarkers.

IF 4 Q1 CLINICAL NEUROLOGY
Ariane Bercu, Carole Dufouil, Stéphanie Debette, Marc Joliot, Ami Tsuchida, Catherine Helmer, Anthony Devaux, Vincent Bouteloup, Cécile Proust-Lima, Hélène Jacqmin-Gadda
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Abstract

Abstract: The utility of brain magnetic resonance imaging (MRI) for predicting dementia is debated. We evaluated the added value of repeated brain MRI, including atrophy and cerebral small vessel disease markers, for dementia prediction. We conducted a landmark competing risk analysis in 1716 participants of the French population-based Three-City Study to predict the 5-year risk of dementia using repeated measures of 41 predictors till year 4 of follow-up. Brain MRI markers improved significantly the individual prediction of dementia after accounting for demographics, health measures, and repeated measures of cognition and functional dependency (area under the ROC curve [95% CI] improved from 0.80 [0.79 to 0.82] to 0.83 [0.81 to 0.84]). Nonetheless, accounting for the change over time through repeated MRIs had little impact on predictive abilities. These results highlight the importance of multimodal analysis to evaluate the added predictive abilities of repeated brain MRI for dementia and offer new insights into the predictive performances of various MRI markers.

Highlights: We evaluated whether repeated brain volumes and cSVD markers improve dementia prediction.The 5-year prediction of dementia is slightly improved when considering brain MRI markers.Measures of hippocampus volume are the main MRI predictors of dementia.Adjusted on cognition, repeated MRI has poor added value over single MRI for dementia prediction.We utilized a longitudinal analysis that considers error-and-missing-prone predictors, and competing death.

通过多模态重复测量预测痴呆症风险:脑磁共振成像生物标志物的附加价值
摘要:脑磁共振成像(MRI)在预测痴呆症方面的实用性还存在争议。我们评估了重复脑磁共振成像(包括脑萎缩和脑小血管疾病标志物)在预测痴呆症方面的附加价值。我们对法国三城人口研究中的 1716 名参与者进行了一项具有里程碑意义的竞争风险分析,通过重复测量 41 个预测指标来预测 5 年痴呆症风险,直至随访到第 4 年。在考虑了人口统计学、健康测量以及认知和功能依赖性的重复测量后,脑磁共振成像标记物显著提高了对痴呆症的个体预测能力(ROC 曲线下面积 [95% CI] 从 0.80 [0.79 至 0.82] 提高到 0.83 [0.81 至 0.84])。尽管如此,通过重复磁共振成像来考虑随时间的变化对预测能力影响不大。这些结果凸显了多模态分析在评估重复脑磁共振成像对痴呆症的额外预测能力方面的重要性,并为各种磁共振成像标记物的预测性能提供了新的见解:我们评估了重复脑容量和cSVD标记物是否能提高痴呆症预测能力。考虑脑磁共振成像标记物后,痴呆症的5年预测能力略有提高。
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来源期刊
CiteScore
7.80
自引率
7.50%
发文量
101
审稿时长
8 weeks
期刊介绍: Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.
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