title: 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.
authors.affiliation: Center for Imaging of Neurodegenerative Diseases, Department of Veterans Affairs Medical Center, San Francisco, CA 94121, USA. duygu.tosun@ucsf.edu
authors.forename: Duygu
authors.initials: D
authors.lastname: Tosun
authors.forename: Pouria
authors.initials: P
authors.lastname: Mojabi
authors.forename: Michael W
authors.initials: MW
authors.lastname: Weiner
authors.forename: Norbert
authors.initials: N
authors.lastname: Schuff
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology / Q000502:physiology; D000544:Alzheimer Disease / Q000473:pathology* / Q000503:physiopathology*; D001921:Brain / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology*; D002540:Cerebral Cortex / Q000469:parasitology / Q000473:pathology / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D003071:Cognition / Q000502:physiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D016015:Logistic Models; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012039:Regional Blood Flow; D012720:Severity of Illness Index; D012815:Signal Processing, Computer-Assisted
references.citation: Rev Med Univ Navarra. 1997 Jan-Mar;41(1):12-8
references.pmid: 9527710
references.citation: Int J Geriatr Psychiatry. 2008 Nov;23(11):1114-8
references.pmid: 18449954
references.citation: Psychiatry Clin Neurosci. 2005 Jun;59(3):280-90
references.pmid: 15896221
references.citation: Neurology. 2008 Feb 12;70(7):512-20
references.pmid: 17898323
references.citation: Psychiatry Res. 2006 Apr 30;146(3):251-61
references.pmid: 16524704
references.citation: Arch Neurol. 1995 Mar;52(3):257-62
references.pmid: 7872878
references.citation: Q J Nucl Med Mol Imaging. 2007 Dec;51(4):357-63
references.pmid: 17220817
references.citation: Radiology. 2009 Mar;250(3):856-66
references.pmid: 19164119
references.citation: IEEE Trans Med Imaging. 1999 Oct;18(10):897-908
references.pmid: 10628949
references.citation: Alzheimers Dement. 2006 Jan;2(1):36-42
references.pmid: 19595854
references.citation: Neuroimage. 2008 Nov 15;43(3):458-69
references.pmid: 18691658
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: Magn Reson Med. 1992 Jan;23(1):37-45
references.pmid: 1734182
references.citation: IEEE Trans Med Imaging. 2009 May;28(5):703-9
references.pmid: 19150788
references.citation: Neurology. 1989 Nov;39(11):1537-9
references.pmid: 2812339
references.citation: J Neuroimaging. 1995 Jul;5 Suppl 1:S45-52
references.pmid: 7626837
references.citation: Acta Neuropathol. 1991;82(4):239-59
references.pmid: 1759558
references.citation: Clin Exp Neurol. 1991;28:56-65
references.pmid: 1821840
references.citation: Brain. 2008 Sep;131(Pt 9):2455-63
references.pmid: 18669506
references.citation: Eur J Nucl Med Mol Imaging. 2002 Dec;29(12):1685-96
references.pmid: 12458405
references.citation: Clin Neurophysiol. 2005 Feb;116(2):364-75
references.pmid: 15661114
references.citation: Neurology. 2005 May 10;64(9):1520-4
references.pmid: 15883311
references.citation: Neuropsychologia. 2008;46(6):1597-612
references.pmid: 18395760
references.citation: Brain. 2002 Aug;125(Pt 8):1772-81
references.pmid: 12135968
references.citation: Neuroimage. 2008 Oct 15;43(1):59-68
references.pmid: 18675918
references.citation: Neurol Res. 2003 Sep;25(6):567-80
references.pmid: 14503010
references.citation: Med Image Anal. 2004 Sep;8(3):295-309
references.pmid: 15450224
references.citation: J Nucl Med. 1994 Feb;35(2):210-6
references.pmid: 8294987
references.citation: Radiology. 2005 Mar;234(3):851-9
references.pmid: 15734937
references.citation: Proc Natl Acad Sci U S A. 2002 Apr 2;99(7):4703-7
references.pmid: 11930016
references.citation: Int J Geriatr Psychiatry. 2003 Apr;18(4):288-91
references.pmid: 12673603
references.citation: IEEE Trans Med Imaging. 2003 Oct;22(10):1332-9
references.pmid: 14552586
references.citation: J Neurol Sci. 2008 Jan 15;264(1-2):27-33
references.pmid: 17764699
references.citation: Psychiatry Res. 2000 Dec 4;100(2):65-74
references.pmid: 11114492
references.citation: Med Phys. 2009 Aug;36(8):3737-47
references.pmid: 19746807
references.citation: Stat Med. 2000 Jun 15-30;19(11-12):1631-44
references.pmid: 10844724
references.citation: IEEE Trans Med Imaging. 2008 Dec;27(12):1739-53
references.pmid: 19033090
references.citation: Neuroimage. 2006 Feb 1;29(3):838-52
references.pmid: 16269250
references.citation: Dement Geriatr Cogn Disord. 2004;17(3):207-14
references.pmid: 14739546
references.citation: Neurology. 2005 Jun 14;64(11):1860-7
references.pmid: 15955934
references.citation: Neuroimage. 2004 Aug;22(4):1754-66
references.pmid: 15275931
references.citation: Neurology. 2006 Oct 10;67(7):1215-20
references.pmid: 17030755
references.citation: Hum Brain Mapp. 2009 Sep;30(9):2766-88
references.pmid: 19172649
references.citation: Neurology. 1998 Feb;50(2):380-3
references.pmid: 9484357
references.citation: Neuroimage. 2007 May 15;36(1):69-87
references.pmid: 17408972
references.citation: Neuroimage. 2008 Jul 1;41(3):835-48
references.pmid: 18434199
references.citation: Hum Brain Mapp. 2006 Jan;27(1):47-62
references.pmid: 16108017
references.citation: Brain. 2007 Jul;130(Pt 7):1777-86
references.pmid: 17533169
references.citation: Neurology. 2005 Aug 23;65(4):565-71
references.pmid: 16116117
references.citation: Arch Neurol. 2003 Aug;60(8):1066-72
references.pmid: 12925361
references.citation: Neurology. 2008 Sep 9;71(11):819-25
references.pmid: 18672473
references.citation: Nucl Med Commun. 2006 Jan;27(1):37-44
references.pmid: 16340722
references.citation: Brain. 2007 Mar;130(Pt 3):720-30
references.pmid: 17293358
references.citation: Neuroimage. 2006 Dec;33(4):1093-103
references.pmid: 17011792
references.citation: Neurology. 1994 Mar;44(3 Pt 1):454-61
references.pmid: 8145915
references.citation: J Neurol Neurosurg Psychiatry. 2003 Feb;74(2):208-12
references.pmid: 12531952
references.citation: Neuroimage. 2005 Mar;25(1):253-66
references.pmid: 15734360
references.citation: Neurobiol Aging. 2004 Oct;25(9):1197-203
references.pmid: 15312965
references.citation: Neuroimage. 2008 Oct 1;42(4):1267-74
references.pmid: 18602481
references.citation: Eur J Nucl Med Mol Imaging. 2002 Jul;29(7):899-906
references.pmid: 12111130
references.citation: Psychiatr Pol. 2005 Sep-Oct;39(5):977-86
references.pmid: 16358596
references.citation: Proc Natl Acad Sci U S A. 2005 Jun 7;102(23):8299-302
references.pmid: 15932949
references.citation: Eur J Nucl Med Mol Imaging. 2006 Jul;33(7):801-9
references.pmid: 16550383
references.citation: J Neuropsychiatry Clin Neurosci. 1997 Winter;9(1):68-74
references.pmid: 9017531
references.citation: J Neurosci. 2003 Feb 1;23(3):994-1005
references.pmid: 12574429
references.citation: Br J Psychiatry. 1989 Jun;154:790-6
references.pmid: 2557110
references.citation: J Nucl Med. 1995 Apr;36(4):690-6
references.pmid: 7699466
references.citation: Neuroimage. 2009 Mar;45(1 Suppl):S3-15
references.pmid: 19041724
references.citation: Neuroimage. 2008 Jun;41(2):277-85
references.pmid: 18400519
references.citation: Neuroimage. 2008 May 15;41(1):19-34
references.pmid: 18378167
references.citation: Brain Cogn. 1996 Dec;32(3):365-83
references.pmid: 8975677
references.citation: J Psychiatry Neurosci. 2008 May;33(3):218-26
references.pmid: 18592038
references.citation: J Gerontol A Biol Sci Med Sci. 2006 Mar;61(3):267-71
references.pmid: 16567376
references.citation: Magn Reson Imaging. 1997;15(10):1133-43
references.pmid: 9408134
references.citation: Hippocampus. 2005;15(4):535-50
references.pmid: 15884035
references.citation: J Nucl Med. 1996 Jul;37(7):1159-65
references.pmid: 8965188
references.citation: Eur J Nucl Med Mol Imaging. 2004 Jul;31(7):975-80
references.pmid: 14991240
references.citation: Am J Physiol Imaging. 1989;4(3):89-96
references.pmid: 2789844
references.citation: Med Image Comput Comput Assist Interv. 2005;8(Pt 2):411-8
references.pmid: 16685986
references.citation: Neuroimage. 2009 Jan 1;44(1):43-50
references.pmid: 18691659
references.citation: Dement Geriatr Cogn Disord. 1999 Nov-Dec;10(6):511-7
references.pmid: 10559568
references.citation: Neurology. 2004 Feb 24;62(4):591-600
references.pmid: 14981176
references.citation: Eur J Radiol. 1999 May;30(2):115-24
references.pmid: 10401592
references.citation: J Clin Epidemiol. 1995 Apr;48(4):473-83
references.pmid: 7722601
references.citation: Neuroimage. 2003 Feb;18(2):525-41
references.pmid: 12595205
references.citation: J Cereb Blood Flow Metab. 2008 Apr;28(4):725-36
references.pmid: 17960142
references.citation: Nihon Ronen Igakkai Zasshi. 1997 Jun;34(6):468-73
references.pmid: 9301261
references.citation: J Cogn Neurosci. 2000 Jan;12(1):1-47
references.pmid: 10769304
references.citation: J Neurol Neurosurg Psychiatry. 1992 Dec;55(12):1182-7
references.pmid: 1479398
references.citation: Dement Geriatr Cogn Disord. 2001 Mar-Apr;12(2):153-7
references.pmid: 11173889
references.citation: J Nucl Med. 2002 Jan;43(1):21-6
references.pmid: 11801698
references.citation: J Nucl Med. 1999 Apr;40(4):522-9
references.pmid: 10210209
references.citation: Neuroimage. 2006 Apr 15;30(3):768-79
references.pmid: 16412666
references.citation: Neuroimage. 2004 Nov;23(3):997-1012
references.pmid: 15528100
references.citation: J Nucl Med. 2007 Dec;48(12):1961-70
references.pmid: 18006622
references.citation: Neuroimage. 2009 Oct 1;47(4):1196-206
references.pmid: 19463961
references.citation: IEEE Trans Med Imaging. 1999 Oct;18(10):885-96
references.pmid: 10628948
references.citation: Alzheimer Dis Assoc Disord. 2004 Oct-Dec;18(4):196-201
references.pmid: 15592130