title: Tract-based spatial statistics: application to mild cognitive impairment.
abstract: OBJECTIVE
  The primary objective of the current investigation was to characterize white matter integrity in different subtypes of mild cognitive impairment (MCI) using tract-based spatial statistics of diffusion tensor imaging.
  
  
  METHODS
  The study participants were divided into 4 groups of 30 subjects each as follows: cognitively healthy controls, amnestic MCI, dysexecutive MCI, and Alzheimer's disease (AD). All subjects underwent a comprehensive neuropsychological assessment, apolipoprotein E genotyping, and 3-tesla MRI. The diffusion tensor was reconstructed and then analyzed using tract-based spatial statistics. The changes in brain white matter tracts were also examined according to the apolipoprotein E ε 4 status.
  
  
  RESULTS
  Compared with controls, amnestic MCI patients showed significant differences in the cerebral white matter, where changes were consistently detectable in the frontal and parietal lobes. We found a moderate impact of the apolipoprotein E ε 4 status on the extent of white matter disruption in the amnestic MCI group. Patients with AD exhibited similar but more extensive alterations, while no significant changes were observed in dysexecutive MCI patients.
  
  
  CONCLUSIONS
  The results from this study indicate that amnestic MCI is the most likely precursor to AD as both conditions share significant white matter damage. By contrast, dysexecutive MCI seems to be characterized by a distinct pathogenesis.
authors.affiliation: Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan County, Taiwan ; Department of Radiology and Intervention, Chang Gung Memorial Hospital, 5 FuHsing Street, Linkou, Taoyuan County, Taiwan.
authors.forename: Yau-Yau
authors.initials: YY
authors.lastname: Wai
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, Linkou, New Taipei 333, Taiwan ; Dementia Center, Chang Gung Memorial Hospital, 5 FuHsing Street, Linkou, Taoyuan County, Taiwan.
authors.forename: Wen-Chuin
authors.initials: WC
authors.lastname: Hsu
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, Linkou, New Taipei 333, Taiwan.
authors.forename: Hon-Chung
authors.initials: HC
authors.lastname: Fung
authors.affiliation: Department of Electrical Engineering, Chang Gung University, 259 WenHua 1st Road, Taoyuan County, Taoyuan, Taiwan.
authors.forename: Jiann-Der
authors.initials: JD
authors.lastname: Lee
authors.affiliation: Department of Electrical Engineering, Chang Gung University, 259 WenHua 1st Road, Taoyuan County, Taoyuan, Taiwan.
authors.forename: Hsiao-Lung
authors.initials: HL
authors.lastname: Chan
authors.affiliation: Department of Radiology and Intervention, Chang Gung Memorial Hospital, 5 FuHsing Street, Linkou, Taoyuan County, Taiwan.
authors.forename: Ming-Lun
authors.initials: ML
authors.lastname: Tsai
authors.affiliation: Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan County, Taiwan ; Department of Radiology and Intervention, Chang Gung Memorial Hospital, 5 FuHsing Street, Linkou, Taoyuan County, Taiwan.
authors.forename: Yu-Chun
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, Linkou, New Taipei 333, Taiwan.
authors.forename: Yih-Ru
authors.initials: YR
authors.lastname: Wu
authors.affiliation: Department of Biomedical Engineering, University at Buffalo, The State University of New York, Buffalo, NY 14260, USA ; Department of Electrical Engineering, University at Buffalo, The State University of New York, Buffalo, NY 14260, USA.
authors.forename: Leslie
authors.initials: L
authors.lastname: Ying
authors.affiliation: Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan County, Taiwan ; Department of Radiology and Intervention, Chang Gung Memorial Hospital, 5 FuHsing Street, Linkou, Taoyuan County, Taiwan ; Neuroscience Research Center, Chang Gung Memorial Hospital, 5 FuHsing Street, Linkou, Taoyuan County, Taiwan ; Institute of Radiological Research, Chang Gung University, Chang Gung Memorial Hospital, 5 FuHsing Street, Linkou, Taoyuan County, Taiwan ; Healthy Aging Research Center, Chang Gung University, 259 WenHua 1st Road, Taoyuan County, Taoyuan, Taiwan.
authors.forename: Jiun-Jie
authors.initials: JJ
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000235:genetics / Q000473:pathology; D053327:Apolipoprotein E4 / Q000235:genetics; D060825:Cognitive Dysfunction / Q000235:genetics / Q000473:pathology*; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D005838:Genotype; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D066127:White Matter / Q000473:pathology*
chemical_list: D053327:Apolipoprotein E4