title: Using the Disease State Fingerprint Tool for Differential Diagnosis of Frontotemporal Dementia and Alzheimer's Disease.
abstract: BACKGROUND
  Disease State Index (DSI) and its visualization, Disease State Fingerprint (DSF), form a computer-assisted clinical decision making tool that combines patient data and compares them with cases with known outcomes.
  
  
  OBJECTIVE
  To investigate the ability of the DSI to diagnose frontotemporal dementia (FTD) and Alzheimer's disease (AD).
  
  
  METHODS
  The study cohort consisted of 38 patients with FTD, 57 with AD and 22 controls. Autopsy verification of FTD with TDP-43 positive pathology was available for 14 and AD pathology for 12 cases. We utilized data from neuropsychological tests, volumetric magnetic resonance imaging, single-photon emission tomography, cerebrospinal fluid biomarkers and the APOE genotype. The DSI classification results were calculated with a combination of leave-one-out cross-validation and bootstrapping. A DSF visualization of a FTD patient is presented as an example.
  
  
  RESULTS
  The DSI distinguishes controls from FTD (area under the receiver-operator curve, AUC = 0.99) and AD (AUC = 1.00) very well and achieves a good differential diagnosis between AD and FTD (AUC = 0.89). In subsamples of autopsy-confirmed cases (AUC = 0.97) and clinically diagnosed cases (AUC = 0.94), differential diagnosis of AD and FTD performs very well.
  
  
  CONCLUSIONS
  DSI is a promising computer-assisted biomarker approach for aiding in the diagnostic process of dementing diseases. Here, DSI separates controls from dementia and differentiates between AD and FTD.
authors.affiliation: Neurology, Institute of Clinical Medicine, University of Eastern Finland, and Departments of, Tampere, Finland.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Muñoz-Ruiz
authors.affiliation: Neurology, Institute of Clinical Medicine, University of Eastern Finland, and Departments of, Tampere, Finland.
authors.forename: Anette
authors.initials: A
authors.lastname: Hall
authors.affiliation: VTT Technical Research Centre of Finland, Tampere, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Mattila
authors.affiliation: VTT Technical Research Centre of Finland, Tampere, Finland.
authors.forename: Juha
authors.initials: J
authors.lastname: Koikkalainen
authors.affiliation: Neurology, Institute of Clinical Medicine, University of Eastern Finland, and Departments of, Tampere, Finland; Neurology, Kuopio University Hospital, Kuopio, Tampere, Finland.
authors.forename: Sanna-Kaisa
authors.initials: SK
authors.lastname: Herukka
authors.affiliation: Radiology, Kuopio University Hospital, Kuopio, Tampere, Finland.
authors.forename: Minna
authors.initials: M
authors.lastname: Husso
authors.affiliation: Neurology, Kuopio University Hospital, Kuopio, Tampere, Finland.
authors.forename: Tuomo
authors.initials: T
authors.lastname: Hänninen
authors.affiliation: Radiology, Kuopio University Hospital, Kuopio, Tampere, Finland.
authors.forename: Ritva
authors.initials: R
authors.lastname: Vanninen
authors.affiliation: Neurology, Institute of Clinical Medicine, University of Eastern Finland, and Departments of, Tampere, Finland; Radiology, Kuopio University Hospital, Kuopio, Tampere, Finland.
authors.forename: Yawu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Neurology, Institute of Clinical Medicine, University of Eastern Finland, and Departments of, Tampere, Finland.
authors.forename: Merja
authors.initials: M
authors.lastname: Hallikainen
authors.affiliation: VTT Technical Research Centre of Finland, Tampere, Finland.
authors.forename: Jyrki
authors.initials: J
authors.lastname: Lötjönen
authors.affiliation: Neurology, Institute of Clinical Medicine, University of Eastern Finland, and Departments of, Tampere, Finland; Neurology, Kuopio University Hospital, Kuopio, Tampere, Finland.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Remes
authors.affiliation: Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden; Rudbeck Laboratory, Department of Clinical/Surgical Pathology, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Irina
authors.initials: I
authors.lastname: Alafuzoff
authors.affiliation: Neurology, Institute of Clinical Medicine, University of Eastern Finland, and Departments of, Tampere, Finland; Neurology, Kuopio University Hospital, Kuopio, Tampere, Finland.
authors.forename: Hilkka
authors.initials: H
authors.lastname: Soininen
authors.affiliation: Neurology, Institute of Clinical Medicine, University of Eastern Finland, and Departments of, Tampere, Finland; Neurology, Kuopio University Hospital, Kuopio, Tampere, Finland.
authors.forename: Päivi
authors.initials: P
authors.lastname: Hartikainen
keywords: Alzheimer's disease; Computer-assisted diagnosis; Frontotemporal dementia; Magnetic resonance imaging; Neuropsychology; Single-photon emission tomography