Joint analysis of structural and perfusion MRI for cognitive assessment and classification of Alzheimer's disease and normal aging

Abstract

Structural magnetic resonance imaging (MRI) of brain tissue loss and physiological imaging of regional cerebral blood flow (rCBF) can provide complimentary information for the characterization of brain disorders, such as Alzheimer’s disease (AD) but studies into gains in classification power for AD using these image modalities jointly have been limited. Our aim in this study was to determine the joint contribution of structural and perfusion-weighted imaging for the classification of AD in a cross-sectional study using an integrated multimodality MRI processing framework and a cortical surface-based analysis approach. We used logistic regression analysis to determine sequentially the value of cortical thickness, rCBF, and cortical thickness and rCBF jointly for classification for diagnosis of AD compared to controls. We further tested the extent to which cortical thinning and reduced rCBF explain individually or together variability in dementia severity. Separate analysis of structural MRI and perfusion-weighted MRI data yielded the well-established pattern of cortical thinning and rCBF reduction in AD, affecting predominantly temporo-parietal brain regions. Using structural MRI and perfusion-weighted MRI jointly indicated that cortical thinning dominated the classification of AD and controls without significant contributions from rCBF. However there was also a positive interaction between reduced rCBF and cortical thinning in the right superior temporal sulcus, implying that structural and physiological brain alterations in AD can be complementary. Compared to reduced rCBF, regional cortical thinning better explained the variability in dementia severity. In conclusion, structural brain alterations compared to physiological variations are the dominant features of MRI in AD.

Alzheimer Disease: New Concepts on Its Neurobiology and the Clinical Role Imaging Will Play

“…Perfusion MR imaging is attractive because disease-specific regional cerebral blood flow information currently obtained with SPECT or FDG PET can be obtained noninvasively with arterial spin labeling in an integrated examination that includes other MR imaging-based modalities (Fig 8). This is an active area of research, and it remains to be seen if perfusion MR imaging can achieve the same diagnostic sensitivity and specificity that has already been demonstrated with FDG PET (177)(178)(179).…”

Magnetic resonance imaging in Alzheimer's Disease Neuroimaging Initiative 2

“…Using an integrated multimodality MRI framework, the UCSF group studied the extent to which cortical thinning and reduced regional cerebral blood flow (rCBF) explain individually or together variability in dementia severity [159, 160]. This study showed that cortical thinning dominated the classification of AD and controls compared to contributions from rCBF.…”

Brain perfusion SPECT in the mouse: Normal pattern according to gender and age

“…Cerebral blood flow is a useful surrogate marker of neuronal activity and is a parameter of primary interest in the diagnosis of a variety of diseases including cerebrovascular disease (Conijn et al, 2012) and stroke (Brumm et al, 2010), epilepsy (Nelissen et al, 2006), brain tumors (Koh et al, 2006) and neurodegenerative diseases (Tosun et al, 2010). In addition, cerebral blood flow is an important covariate in all studies of brain function involving the intravenous injection of a tracer, since the transfer of tracer from arterial blood to tissue depends on the regional cerebral blood flow (rCBF).…”