title: Thinner temporal and parietal cortex is related to incident clinical progression to dementia in patients with subjective cognitive decline.
abstract: BACKGROUND
  We aimed to investigate if thinner cortex of the Alzheimer's disease (AD)-signature region was related to clinical progression in patients with subjective cognitive decline (SCD).
  
  
  METHODS
  We included 302 SCD patients with clinical follow-up (≥1 year) and three-dimensional T1 magnetic resonance imaging. We estimated AD-signature cortical thickness, consisting of nine frontal, parietal, and temporal gyri and hippocampal volume. We used Cox proportional hazard models (hazard ratios and 95% confidence intervals) to evaluate cortical thickness in relation to clinical progression to mild cognitive impairment (MCI) or dementia.
  
  
  RESULTS
  After a follow-up of the mean (standard deviation) 3 (2) years, 49 patients (16%) showed clinical progression to MCI (n= 32), AD (n= 9), or non-AD dementia (n= 8). Hippocampal volumes, thinner cortex of the AD-signature (hazard ratio [95% confidence interval], 5 [2-17]) and various AD-signature subcomponents were associated with increased risk of clinical progression. Stratified analyses showed that thinner AD-signature cortex was specifically predictive for clinical progression to dementia but not to MCI.
  
  
  CONCLUSIONS
  In SCD patients, thinner regional cortex is associated with clinical progression to dementia.
authors.affiliation: Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Sander C J
authors.initials: SC
authors.lastname: Verfaillie
authors.affiliation: Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Betty
authors.initials: B
authors.lastname: Tijms
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Adriaan
authors.initials: A
authors.lastname: Versteeg
authors.affiliation: Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Marije R
authors.initials: MR
authors.lastname: Benedictus
authors.affiliation: Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Femke H
authors.initials: FH
authors.lastname: Bouwman
authors.affiliation: Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands; Institute of Neurology, UCL, London, UK; Institute of Healthcare Engineering, UCL, London, UK.
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands; Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Hugo
authors.initials: H
authors.lastname: Vrenken
authors.affiliation: Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Wiesje M
authors.initials: WM
authors.lastname: van der Flier
keywords: Alzheimer's disease cortical signature; Cognitive complaint; Cognitively normal; Cortical thickness; Dementia; MCI; MRI; Subjective cognitive decline