title: Metabolic connectivity for differential diagnosis of dementing disorders.
abstract: Presently, visual and quantitative approaches for image-supported diagnosis of dementing disorders rely on regional intensity rather than on connectivity measurements. Here, we test metabolic connectivity for differentiation between Alzheimer's disease and frontotemporal lobar degeneration. Positron emission tomography with 18F-fluorodeoxyglucose was conducted in 47 patients with mild Alzheimer's disease, 52 patients with mild frontotemporal lobar degeneration, and 45 healthy elderly subjects. Sparse inverse covariance estimation and selection were used to identify patterns of metabolic, inter-subject covariance on the basis of 60 regional values. Relative to healthy subjects, significantly more pathological within-lobe connections were found in the parietal lobe of patients with Alzheimer's disease, and in the frontal and temporal lobes of subjects with frontotemporal lobar degeneration. Relative to the frontotemporal lobar degeneration group, more pathological connections between the parietal and temporal lobe were found in the Alzheimer's disease group. The obtained connectivity patterns differentiated between two patients groups with an overall accuracy of 83%. Linear discriminant analysis and univariate methods provided an accuracy of 74% and 69%, respectively. There are characteristic patterns of abnormal metabolic connectivity in mild Alzheimer's disease and frontotemporal lobar degeneration. Such patterns can be utilized for single-subject analyses and might be more accurate in the differential diagnosis of dementing disorders than traditional intensity-based analyses.
authors.affiliation: Department of Nuclear Medicine, Technische Universität München, Munich, Germany.|Computer Aided Medical Procedures and Augmented Reality, Technische Universität München, Munich, Germany.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Titov
authors.affiliation: Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany.
authors.forename: Janine
authors.initials: J
authors.lastname: Diehl-Schmid
authors.affiliation: Department of Nuclear Medicine, Technische Universität München, Munich, Germany.
authors.forename: Kuangyu
authors.initials: K
authors.lastname: Shi
authors.affiliation: Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany.|Neuroepidemiology and Ageing Research Unit, School of Public Health, The Imperial College of Science, Technology and Medicine, London, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Perneczky
authors.affiliation: Department of Industrial Engineering, Arizona State University, Tempe, AZ, USA.
authors.forename: Na
authors.initials: N
authors.lastname: Zou
authors.affiliation: Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany.
authors.forename: Timo
authors.initials: T
authors.lastname: Grimmer
authors.affiliation: Department of Industrial Engineering, Arizona State University, Tempe, AZ, USA.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Nuclear Medicine, Technische Universität München, Munich, Germany.|Department of Nuclear Medicine, Universität zu Köln, Cologne, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Drzezga
authors.affiliation: Department of Nuclear Medicine, Technische Universität München, Munich, Germany igor.yakushev@tum.de.|Neuroimaging Center at Technische Universität München (TUM-NIC), Munich, Germany.
authors.forename: Igor
authors.initials: I
authors.lastname: Yakushev
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D001931:Brain Mapping / Q000379:methods; D016022:Case-Control Studies; D003704:Dementia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D057174:Frontotemporal Lobar Degeneration / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D008297:Male; D053858:Metabolic Networks and Pathways; D010296:Parietal Lobe / Q000378:metabolism; D049268:Positron-Emission Tomography; D013702:Temporal Lobe / Q000378:metabolism
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Alzheimer's disease; FDG PET; frontotemporal lobar degeneration; multivariate analysis; positron emission tomography