A Biomarker for Alzheimer’s Disease Based on Patterns of Regional Brain Atrophy

Abstract

Introduction: It has been shown that Alzheimer's disease (AD) is accompanied by marked structural brain changes that can be detected several years before clinical diagnosis via structural magnetic resonance (MR) imaging. In this study, we developed a structural MRbased biomarker for in vivo detection of AD using a supervised machine learning approach. Based on an individual's pattern of brain atrophy a continuous AD score is assigned which measures the similarity with brain atrophy patterns seen in clinical cases of AD. Methods: The underlying statistical model was trained with MR scans of patients and healthy controls from the Alzheimer's Disease Neuroimaging Initiative (ADNI-1 screening). Validation was performed within ADNI-1 and in an independent patient sample from the Open Access Series of Imaging Studies (OASIS-1). In addition, our analyses included data from a large general population sample of the Study of Health in Pomerania (SHIP-Trend). Results: Based on the proposed AD score we were able to differentiate patients from healthy controls in ADNI-1 and OASIS-1 with an accuracy of 89% (AUC = 95%) and 87% (AUC = 93%), respectively. Moreover, we found the AD score to be significantly associated with cognitive functioning as assessed by the Mini-Mental State Examination in the OASIS-1 sample after correcting for diagnosis, age, sex, age•sex, and total intracranial volume (Cohen's f 2 = 0.13). Additional analyses showed that the prediction accuracy of AD status based on both the AD score and the MMSE score is significantly higher than when using just one of them. In SHIP-Trend we found the AD score to be weakly but significantly associated with a test of verbal memory consisting of an immediate and a delayed word list recall (again after correcting for age, sex, age•sex, and total intracranial volume, Cohen's f 2 = 0.009). This association was mainly driven by the immediate recall performance. Discussion: In summary, our proposed biomarker well differentiated between patients and healthy controls in an independent test sample. It was associated with measures of

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“…However, the use of the segmentation methods has not yet demonstrated its validity in the study of healthy adults at risk of AD as the results have been inconclusive [ 130 ]. Very recently, an MRI biomarker for in vivo AD diagnosis based on the use of FreeSurfer and a supervised machine learning approach was reported [ 131 ]. Based on an individual’s pattern of brain atrophy, a continuous AD score is assigned which measures the similarity with brain atrophy patterns seen in clinical cases of AD [ 131 ].…”

“…Very recently, an MRI biomarker for in vivo AD diagnosis based on the use of FreeSurfer and a supervised machine learning approach was reported [ 131 ]. Based on an individual’s pattern of brain atrophy, a continuous AD score is assigned which measures the similarity with brain atrophy patterns seen in clinical cases of AD [ 131 ].…”

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