title: Basal Forebrain and Hippocampus as Predictors of Conversion to Alzheimer's Disease in Patients with Mild Cognitive Impairment - A Multicenter DTI and Volumetry Study.
abstract: BACKGROUND
  Hippocampal grey matter (GM) atrophy predicts conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD). Pilot data suggests that mean diffusivity (MD) in the hippocampus, as measured with diffusion tensor imaging (DTI), may be a more accurate predictor of conversion than hippocampus volume. In addition, previous studies suggest that volume of the cholinergic basal forebrain may reach a diagnostic accuracy superior to hippocampal volume in MCI.
  
  
  OBJECTIVE
  The present study investigated whether increased MD and decreased volume of the hippocampus, the basal forebrain and other AD-typical regions predicted time to conversion from MCI to AD dementia.
  
  
  METHODS
  79 MCI patients with DTI and T1-weighted magnetic resonance imaging (MRI) were retrospectively included from the European DTI Study in Dementia (EDSD) dataset. Of these participants, 35 converted to AD dementia after 6-46 months (mean: 21 months). We used Cox regression to estimate the relative conversion risk predicted by MD values and GM volumes, controlling for age, gender, education and center.
  
  
  RESULTS
  Decreased GM volume in all investigated regions predicted an increased risk for conversion. Additionally, increased MD in the right basal forebrain predicted increased conversion risk. Reduced volume of the right hippocampus was the only significant predictor in a stepwise model combining all predictor variables.
  
  
  CONCLUSIONS
  Volume reduction of the hippocampus, the basal forebrain and other AD-related regions was predictive of increased risk for conversion from MCI to AD. In this study, volume was superior to MD in predicting conversion.
authors.affiliation: DZNE, German Center for Neurodegenerative Diseases, Rostock, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Brueggen
authors.affiliation: DZNE, German Center for Neurodegenerative Diseases, Rostock, Germany.|MMIS group, University of Rostock, Rostock, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Dyrba
authors.affiliation: Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, Netherlands.
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
authors.affiliation: Department of Geriatric Psychiatry, Zentralinstitut für Seelische Gesundheit Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: Lucrezia
authors.initials: L
authors.lastname: Hausner
authors.affiliation: Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Scientific Institute and University Vita-Salute San Raffaele, Milano, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Filippi
authors.affiliation: DZNE, German Center for Neurodegenerative Diseases, Magdeburg, Germany.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Nestor
authors.affiliation: Department of Radiology, University of Rostock, Rostock, Germany.
authors.forename: Karlheinz
authors.initials: K
authors.lastname: Hauenstein
authors.affiliation: Department of Psychiatry and Psychotherapy, Freiburg Brain Imaging, University Clinic Freiburg, Freiburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Klöppel
authors.affiliation: DZNE, German Center for Neurodegenerative Diseases, Rostock, Germany.
authors.forename: Michel J
authors.initials: MJ
authors.lastname: Grothe
authors.affiliation: Department of Psychosomatic Medicine, University Medicine Rostock, Rostock, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kasper
authors.affiliation: DZNE, German Center for Neurodegenerative Diseases, Rostock, Germany.|Department of Psychosomatic Medicine, University Medicine Rostock, Rostock, Germany.
authors.forename: Stefan J
authors.initials: SJ
authors.lastname: Teipel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis*; D001284:Atrophy; D066187:Basal Forebrain / Q000473:pathology*; D060825:Cognitive Dysfunction / Q000150:complications / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D018450:Disease Progression; D005060:Europe; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D007391:International Cooperation; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D018709:Statistics, Nonparametric
keywords: Alzheimer’s disease; Diffusion tensor imaging; Mild Cognitive Impairment; atrophy; basal forebrain; cholinergic; early diagnosis; magnetic resonance imaging