Subtypes based on cerebrospinal fluid and magnetic resonance imaging markers in normal elderly predict cognitive decline

NEUROBIOLOGY OF AGING

卷:31

Article

Nettiksimmons, J.¹  Harvey, D.¹  Brewer, J.^2,3  Carmichael, O.⁴  DeCarli, C.⁴  Jack, C. R., Jr.⁵  Petersen, R.⁵  Shaw, L. M.^6,7  Trojanowski, J. Q.^6,7  Weiner, M. W.^6,7  Beckett, L.¹ 

[1] Univ Calif Davis, Dept Publ Hlth Sci, Div Biostat, Davis, CA 95616 USA

[2] Univ Calif San Diego, Dept Radiol, La Jolla, CA 92093 USA

[3] Univ Calif San Diego, Dept Neurosci, La Jolla, CA 92093 USA

[4] Univ Calif Davis, Dept Neurol, Davis, CA 95616 USA

[5] Mayo Clin, Coll Med, Dept Neurol, Rochester, MN USA

[6] Univ Penn, Sch Med, Dept Pathol & Lab Med,Ctr Neurodegenerat Dis Res, Inst Aging,Alzheimers Dis Core Ctr, Philadelphia, PA 19104 USA

[7] Univ Calif San Francisco, Ctr Imaging Neurodegenerat Dis, San Francisco, CA 94143 USA

关键词: Alzheimer's disease;    Dementia;    Early diagnosis;    Cerebrospinal fluid;    Tau protein;    Amyloid beta-protein;    Structural magnetic resonance imaging;    Hippocampal volume;    Cognition;    Clustering;    Normal controls;   

DOI  :  10.1016/j.neurobiolaging.2010.04.025

来源: Elsevier

【 摘 要 】

Cerebrospinal fluid (CSF) and structural magnetic resonance imaging (MRI) show patterns of change in Alzheimer's disease (AD) that precede dementia. The Alzheimer's Disease Neuroimaging Initiative (ADNI) studied normal controls (NC), subjects with mild cognitive impairment (MCI), and subjects with AD to identify patterns of biomarkers to aid in early diagnosis and effective treatment of AD. Two hundred twenty-two NC underwent baseline MRI and clinical examination at baseline and at least one follow-up. One hundred twelve also provided CSF at baseline. Unsupervised clustering based on initial CSF and MRI measures was used to identify clusters of participants with similar profiles. Repeated measures regression modeling assessed the relationship of individual measures, and of cluster membership, to cognitive change over 3 years. Most individuals showed little cognitive change. Individual biomarkers had limited predictive value for cognitive decline, but membership in the cluster with the most extreme profile was associated with more rapid decline in ADAS-cog. Subtypes among NC based on multiple biomarkers may represent the earliest stages of subclinical cognitive decline and AD. (C) 2010 Elsevier Inc. All rights reserved.

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