title: Regionally-specific diffusion tensor imaging in mild cognitive impairment and Alzheimer's disease.
abstract: BACKGROUND
  Diffusion tensor imaging (DTI) studies have shown significant cross-sectional differences among normal controls (NC) mild cognitive impairment (MCI) and Alzheimer's disease (AD) patients in several fiber tracts in the brain, but longitudinal assessment is needed.
  
  
  METHODS
  We studied 75 participants (25 NC, 25 amnestic MCI, and 25 mild AD) at baseline and 3 months later, with both imaging and clinical evaluations. Fractional anisotropy (FA) was analyzed in regions of interest (ROIs) in: (1) fornix, (2) cingulum bundle, (3) splenium, and (4) cerebral peduncles. Clinical data included assessments of clinical severity and cognitive function. Cross-sectional and longitudinal differences in FA, within each ROI, were analyzed with generalized estimating equations (GEE).
  
  
  RESULTS
  Cross-sectionally, AD patients had lower FA than NC (p<0.05) at baseline and 3 months in the fornix and anterior portion of the cingulum bundle. Compared to MCI, AD cases had lower FA (p<0.05) in these regions and the splenium at 0 and 3 months. Both the fornix and anterior cingulum correlated across all clinical cognitive scores; lower FA in these ROIs corresponded to worse performance. Over the course of 3 months, when the subjects were clinically stable, the ROIs were also largely stable.
  
  
  CONCLUSIONS
  Using DTI, findings indicate FA is decreased in specific fiber tracts among groups of subjects that vary along the spectrum from normal to AD, and that this measure is stable over short periods of time. The fornix is a predominant outflow tract of the hippocampus and may be an important indicator of AD progression.
authors.affiliation: Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA. mmielke1@jhmi.edu
authors.forename: M M
authors.initials: MM
authors.lastname: Mielke
authors.forename: N A
authors.initials: NA
authors.lastname: Kozauer
authors.forename: K C G
authors.initials: KC
authors.lastname: Chan
authors.forename: M
authors.initials: M
authors.lastname: George
authors.forename: J
authors.initials: J
authors.lastname: Toroney
authors.forename: M
authors.initials: M
authors.lastname: Zerrate
authors.forename: K
authors.initials: K
authors.lastname: Bandeen-Roche
authors.forename: M-C
authors.initials: MC
authors.lastname: Wang
authors.forename: P
authors.initials: P
authors.lastname: Vanzijl
authors.forename: J J
authors.initials: JJ
authors.lastname: Pekar
authors.forename: S
authors.initials: S
authors.lastname: Mori
authors.forename: C G
authors.initials: CG
authors.lastname: Lyketsos
authors.forename: M
authors.initials: M
authors.lastname: Albert
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000473:pathology*; D016880:Anisotropy; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D018450:Disease Progression; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged