Differentiation Between Dementia With Lewy Bodies And Alzheimer's Disease Using Voxel-Based Morphometry Of Structural MRI: A Multicenter Study.

Alzheimer’s disease MRI dementia with Lewy bodies voxel-based morphometry

Journal

Neuropsychiatric disease and treatment
ISSN: 1176-6328
Titre abrégé: Neuropsychiatr Dis Treat
Pays: New Zealand
ID NLM: 101240304

Informations de publication

Date de publication:
2019
Historique:
received: 12 07 2019
accepted: 04 09 2019
entrez: 2 10 2019
pubmed: 2 10 2019
medline: 2 10 2019
Statut: epublish

Résumé

The differential diagnosis of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) is particularly important because DLB patients respond better to cholinesterase inhibitors but sometimes exhibit sensitivity to neuroleptics, which may cause worsening of clinical status. Antemortem voxel-based morphometry (VBM) using structural MRI has previously revealed that patients with DLB have normal hippocampal volume, but atrophy in the dorsal mesopontine area. The aim of this multicenter study was to determine whether VBM of the brain stem in addition to that of medial temporal lobe structures improves the differential diagnosis of AD and DLB. We retrospectively chose 624 patients who were clinically diagnosed with either DLB (239 patients) or AD (385 patients) from 10 institutes using different MR scanners with different magnetic field strengths. In all cases, VBM was performed on 3D T1-weighted images. The degree of local atrophy was calculated using Z-score by comparison with a database of normal volumes of interest (VOIs) in medial temporal lobe (MTL) and the dorsal brain stem (DBS). The discrimination of DLB and AD was evaluated using Z-score values in these two VOIs. MRI data from 414 patients were used as the training data set to determine the classification criteria, with the MRI data from the remaining 210 patients used as the test data set. The DLB and AD patients did not differ with respect to mean age or Mini-Mental State Examination scores. Z-index scores showed that there was significantly more atrophy in MTL of AD patients, compared to DLB patients and in DBS of DLB patients, compared to AD patients. The discrimination accuracies of VBM were 63.3% in the test data set and 73.4% in the training data set. VBM of DBS in addition to that of MTL improves the differentiation of DLB and AD.

Sections du résumé

BACKGROUND BACKGROUND
The differential diagnosis of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) is particularly important because DLB patients respond better to cholinesterase inhibitors but sometimes exhibit sensitivity to neuroleptics, which may cause worsening of clinical status. Antemortem voxel-based morphometry (VBM) using structural MRI has previously revealed that patients with DLB have normal hippocampal volume, but atrophy in the dorsal mesopontine area.
OBJECTIVES OBJECTIVE
The aim of this multicenter study was to determine whether VBM of the brain stem in addition to that of medial temporal lobe structures improves the differential diagnosis of AD and DLB.
METHODS METHODS
We retrospectively chose 624 patients who were clinically diagnosed with either DLB (239 patients) or AD (385 patients) from 10 institutes using different MR scanners with different magnetic field strengths. In all cases, VBM was performed on 3D T1-weighted images. The degree of local atrophy was calculated using Z-score by comparison with a database of normal volumes of interest (VOIs) in medial temporal lobe (MTL) and the dorsal brain stem (DBS). The discrimination of DLB and AD was evaluated using Z-score values in these two VOIs. MRI data from 414 patients were used as the training data set to determine the classification criteria, with the MRI data from the remaining 210 patients used as the test data set.
RESULTS RESULTS
The DLB and AD patients did not differ with respect to mean age or Mini-Mental State Examination scores. Z-index scores showed that there was significantly more atrophy in MTL of AD patients, compared to DLB patients and in DBS of DLB patients, compared to AD patients. The discrimination accuracies of VBM were 63.3% in the test data set and 73.4% in the training data set.
CONCLUSION CONCLUSIONS
VBM of DBS in addition to that of MTL improves the differentiation of DLB and AD.

Identifiants

DOI: 10.2147/NDT.S222966 PMID: 31571887 PMC: PMC6757232
pubmed: 31571887
doi: 10.2147/NDT.S222966
pii: 222966
pmc: PMC6757232
doi:

Types de publication

Journal Article

Langues

eng

Pagination

2715-2722

Informations de copyright

© 2019 Matsuda et al.

Déclaration de conflit d'intérêts

TO, TG, and KS are employees of Dai Nippon Printing Co., Ltd. Dai Nippon Printing Co., Ltd is a consignment contractor between companies. TO, TG, and KS have a patent US 10285657 B2 issued, patents JP 2016-64004 A, EP 3199102 A1, and CN 106659424 A pending. TO, TG and KS report and served for outsourcing contract between companies for software development-related work, call center-related business, system-related work, work related to creating support materials, and printing related business. The authors report no other conflicts of interest in this work.

Références

Parkinsonism Relat Disord. 2015 Sep;21(9):1049-55
pubmed: 26109553
Neurology. 2017 Jul 4;89(1):88-100
pubmed: 28592453
J Neurol Neurosurg Psychiatry. 2017 Nov;88(11):908-916
pubmed: 28473626
Parkinsonism Relat Disord. 2015 Jul;21(7):683-91
pubmed: 25920541
AJNR Am J Neuroradiol. 2012 Jun;33(6):1109-14
pubmed: 22300935
Neurology. 2012 Aug 7;79(6):553-60
pubmed: 22843258
Brain. 2004 Apr;127(Pt 4):791-800
pubmed: 14749292
Aging Dis. 2018 Aug 1;9(4):755-760
pubmed: 30090663
Neuroimage. 2002 Oct;17(2):618-30
pubmed: 12377138
Medicine (Baltimore). 2017 May;96(21):e6967
pubmed: 28538394
Int J Geriatr Psychiatry. 2017 Jun;32(6):615-623
pubmed: 27197956
Neuroradiology. 2013 May;55(5):559-66
pubmed: 23322456
Neurology. 2007 Dec 11;69(24):2197-204
pubmed: 17568013
Hell J Nucl Med. 2018 Jan-Apr;21(1):60-68
pubmed: 29550847
Neuroreport. 2004 Aug 6;15(11):1711-4
pubmed: 15257132
Brain. 2007 Mar;130(Pt 3):708-19
pubmed: 17267521
Neurosci Lett. 2010 Dec 3;486(1):19-23
pubmed: 20851165
Aging Dis. 2013 Feb;4(1):29-37
pubmed: 23423504
Neurology. 2005 Dec 27;65(12):1863-72
pubmed: 16237129
Arch Neurol. 1994 Sep;51(9):888-95
pubmed: 8080388
Int J Geriatr Psychiatry. 2015 Nov;30(11):1135-46
pubmed: 26270627
AJNR Am J Neuroradiol. 2010 Nov;31(10):1873-8
pubmed: 20634303
Front Hum Neurosci. 2013 Jul 24;7:400
pubmed: 23898254
Alzheimers Dement. 2011 May;7(3):263-9
pubmed: 21514250
Sci Rep. 2017 Aug 25;7(1):9437
pubmed: 28842567
J Neurol. 2012 Jan;259(1):147-54
pubmed: 21717194
Mov Disord. 2010 Jan 15;25(1):28-34
pubmed: 19908327
Int Psychogeriatr. 2012 Apr;24(4):532-40
pubmed: 22126938
Curr Alzheimer Res. 2017;14(2):143-153
pubmed: 27774875
Neurology. 2013 Nov 5;81(19):1681-9
pubmed: 24107861
Neurology. 2016 Nov 29;87(22):2317-2323
pubmed: 27807186

Auteurs

Hiroshi Matsuda (H)

Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
ORCID: 0000-0002-6297-9897

Kota Yokoyama (K)

Department of Radiology, National Center Hospital of Neurology and Psychiatry, Kodaira, Tokyo, Japan.

Noriko Sato (N)

Department of Radiology, National Center Hospital of Neurology and Psychiatry, Kodaira, Tokyo, Japan.

Kengo Ito (K)

Innovation Center for Clinical Research, National Center for Geriatrics and Gerontology, Obu, Japan.

Kiyotaka Nemoto (K)

Department of Psychiatry, Faculty of Medicine, University of Tsukuba Hospital, Tsukuba, Japan.
ORCID: 0000-0001-8623-9829

Hiroshi Oba (H)

Department of Radiology, Teikyo University Hospital, Itabashi-ku, Tokyo, Japan.

Haruo Hanyu (H)

Department of Geriatric Medicine, Tokyo Medical University Hospital, Shinjuku-ku, Tokyo, Japan.

Hidekazu Kanetaka (H)

Department of Geriatric Medicine, Tokyo Medical University Hospital, Shinjuku-ku, Tokyo, Japan.

Sunao Mizumura (S)

Department of Radiology, Toho University Omori Medical Center, Oota-ku, Tokyo, Japan.

Shin Kitamura (S)

Department of Internal Medicine, Nippon Medical School Musashi Kosugi Hospital, Kawasaki, Japan.

Hitoshi Shinotoh (H)

Department of Functional Brain Imaging Research, Clinical Research Cluster, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.

Hitoshi Shimada (H)

Department of Functional Brain Imaging Research, Clinical Research Cluster, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.

Tetsuya Suhara (T)

Department of Functional Brain Imaging Research, Clinical Research Cluster, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.

Hitoshi Terada (H)

Department of Radiology, Toho University Sakura Medical Center, Sakura, Japan.

Tomoya Nakatsuka (T)

Department of Radiology, Toho University Sakura Medical Center, Sakura, Japan.

Shinobu Kawakatsu (S)

Department of Neuropsychiatry, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu, Japan.
ORCID: 0000-0003-4074-1041

Hiroshi Hayashi (H)

Department of Psychiatry, Yamagata University School of Medicine, Yamagata, Japan.
ORCID: 0000-0001-5855-491X

Takashi Asada (T)

Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, Bunkyo-ku, Tokyo, Japan.

Tetsutaro Ono (T)

2nd Group, 2nd Planning Department, 1st Integrated Communication Division, Communication and Information Center, Information Innovation Operations, Dai Nippon Printing Co., Ltd., Tokyo, Japan.

Tomoaki Goto (T)

2nd Group, 2nd Planning Department, 1st Integrated Communication Division, Communication and Information Center, Information Innovation Operations, Dai Nippon Printing Co., Ltd., Tokyo, Japan.

Keiko Shigemori (K)

2nd Group, 2nd Planning Department, 1st Integrated Communication Division, Communication and Information Center, Information Innovation Operations, Dai Nippon Printing Co., Ltd., Tokyo, Japan.

Classifications MeSH