Utility of Molecular and Structural Brain Imaging to Predict Progression from Mild Cognitive Impairment to Dementia

作者：Lan Martin J^*; Ogden R Todd; Kumar Dileep; Stern Yaakov; Parsey Ramin V; Pelton Gregory H; Rubin Falcone Harry; Pradhaban Gnanavalli; Zanderigo Francesca; Miller Jeffrey M; Mann J John; Devanand D P

来源：Journal of Alzheimer's Disease, 2017, 60(3): 939-947.

DOI：10.3233/JAD-161284

• Alzheimer's disease
• mild cognitive impairment
• prognosis
• PET
• volumetric MRI

This project compares three neuroimaging biomarkers to predict progression to dementia in subjects with mild cognitive impairment (MCI). Eighty-eight subjects with MCI and 40 healthy controls (HCs) were recruited. Subjects had a 3T magnetic resonance imaging (MRI) scan, and two positron emission tomography (PET) scans, one with Pittsburgh compound B ([C-11] PIB) and one with fluorodeoxyglucose ([F-18] FDG). MCI subjects were followed for up to 4 y and progression to dementia was assessed on an annual basis. MCI subjects had higher [C-11] PIB binding potential (BPND) than HCs in multiple brain regions, and lower hippocampus volumes. [C-11] PIB BPND, [F-18] FDG standard uptake value ratio (SUVR), and hippocampus volume were associated with time to progression to dementia using a Cox proportional hazards model. [F-18] FDG SUVR demonstrated the most statistically significant association with progression, followed by [C-11] PIB BPND and then hippocampus volume. [C-11] PIB BPND and [F-18] FDG SUVR were independently predictive, suggesting that combining these measures is useful to increase accuracy in the prediction of progression to dementia. Hippocampus volume also had independent predictive properties to [C-11] PIB BPND, but did not add predictive power when combined with the [F-18] FDG SUVR data. This work suggests that PET imaging with both [C-11] PIB and [F-18] FDG may help to determine which MCI subjects are likely to progress to AD, possibly directing future treatment options.