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      The Sporadic Early‐onset Alzheimer's Disease Signature Of Atrophy: Preliminary Findings From The Longitudinal Early‐onset Alzheimer's Disease Study (LEADS) Cohort

      1 , 1 , 1 , 1 , 1 , 2 , 3 , 4 , 5 , 6 , 5 , 5 , 7 , 4 , 8 , 9 , 9 , 9 , 9 , 10 , 11 , 12 , 5 , 4 , 5 , 9 , 13 , 8 , 14 , 15 , 16 , 15 , 17 , 8 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 23 , 25 , 26 , 27 , 28 , 21 , 7 , 9 , 4 , 5 , 29 , 1 , the LEADS Consortium
      Alzheimer's & Dementia
      Wiley

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          Abstract

          INTRODUCTION

          Magnetic resonance imaging (MRI) research has advanced our understanding of neurodegeneration in sporadic early‐onset Alzheimer's disease (EOAD) but studies include small samples, mostly amnestic EOAD, and have not focused on developing an MRI biomarker.

          METHODS

          We analyzed MRI scans to define the sporadic EOAD‐signature atrophy in a small sample (n = 25) of Massachusetts General Hospital (MGH) EOAD patients, investigated its reproducibility in the large longitudinal early‐onset Alzheimer's disease study (LEADS) sample (n = 211), and investigated the relationship of the magnitude of atrophy with cognitive impairment.

          RESULTS

          The EOAD‐signature atrophy was replicated across the two cohorts, with prominent atrophy in the caudal lateral temporal cortex, inferior parietal lobule, and posterior cingulate and precuneus cortices, and with relative sparing of the medial temporal lobe. The magnitude of EOAD‐signature atrophy was associated with the severity of cognitive impairment.

          DISCUSSION

          The EOAD‐signature atrophy is a reliable and clinically valid biomarker of AD‐related neurodegeneration that could be used in clinical trials for EOAD.

          Highlights

          • We developed an early‐onset Alzheimer's disease (EOAD)–signature of atrophy based on magnetic resonance imaging (MRI) scans.

          • EOAD signature was robustly reproducible across two independent patient cohorts.

          • EOAD signature included prominent atrophy in parietal and posterior temporal cortex.

          • The EOAD‐signature atrophy was associated with the severity of cognitive impairment.

          • EOAD signature is a reliable and clinically valid biomarker of neurodegeneration.

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          Most cited references69

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          The diagnosis of dementia due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease

          The National Institute on Aging and the Alzheimer's Association charged a workgroup with the task of revising the 1984 criteria for Alzheimer's disease (AD) dementia. The workgroup sought to ensure that the revised criteria would be flexible enough to be used by both general healthcare providers without access to neuropsychological testing, advanced imaging, and cerebrospinal fluid measures, and specialized investigators involved in research or in clinical trial studies who would have these tools available. We present criteria for all-cause dementia and for AD dementia. We retained the general framework of probable AD dementia from the 1984 criteria. On the basis of the past 27 years of experience, we made several changes in the clinical criteria for the diagnosis. We also retained the term possible AD dementia, but redefined it in a manner more focused than before. Biomarker evidence was also integrated into the diagnostic formulations for probable and possible AD dementia for use in research settings. The core clinical criteria for AD dementia will continue to be the cornerstone of the diagnosis in clinical practice, but biomarker evidence is expected to enhance the pathophysiological specificity of the diagnosis of AD dementia. Much work lies ahead for validating the biomarker diagnosis of AD dementia. Copyright © 2011. Published by Elsevier Inc.
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            An automated labeling system for subdividing the human cerebral cortex on MRI scans into gyral based regions of interest.

            In this study, we have assessed the validity and reliability of an automated labeling system that we have developed for subdividing the human cerebral cortex on magnetic resonance images into gyral based regions of interest (ROIs). Using a dataset of 40 MRI scans we manually identified 34 cortical ROIs in each of the individual hemispheres. This information was then encoded in the form of an atlas that was utilized to automatically label ROIs. To examine the validity, as well as the intra- and inter-rater reliability of the automated system, we used both intraclass correlation coefficients (ICC), and a new method known as mean distance maps, to assess the degree of mismatch between the manual and the automated sets of ROIs. When compared with the manual ROIs, the automated ROIs were highly accurate, with an average ICC of 0.835 across all of the ROIs, and a mean distance error of less than 1 mm. Intra- and inter-rater comparisons yielded little to no difference between the sets of ROIs. These findings suggest that the automated method we have developed for subdividing the human cerebral cortex into standard gyral-based neuroanatomical regions is both anatomically valid and reliable. This method may be useful for both morphometric and functional studies of the cerebral cortex as well as for clinical investigations aimed at tracking the evolution of disease-induced changes over time, including clinical trials in which MRI-based measures are used to examine response to treatment.
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              “Mini-mental state”

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                Author and article information

                Journal
                Alzheimer's & Dementia
                Alzheimer's & Dementia
                Wiley
                1552-5260
                1552-5279
                October 18 2023
                Affiliations
                [1 ] Department of Neurology Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA
                [2 ] Alzheimer's Therapeutic Research Institute University of Southern California San Diego California USA
                [3 ] Department of Public Health Sciences University of California – Davis Davis California USA
                [4 ] Department of Neurology Indiana University School of Medicine Indianapolis Indiana USA
                [5 ] Department of Medical and Molecular Genetics Indiana University School of Medicine Indianapolis Indiana USA
                [6 ] Department of Biostatistics, Center for Statistical Sciences Brown University Providence Rhode Island USA
                [7 ] Medical & Scientific Relations Division Alzheimer's Association Chicago Illinois USA
                [8 ] Department of Radiology Mayo Clinic Rochester Minnesota USA
                [9 ] Department of Neurology University of California – San Francisco San Francisco California USA
                [10 ] Department of Radiology University of Michigan Ann Arbor Michigan USA
                [11 ] Department of Epidemiology University of Washington Seattle Washington USA
                [12 ] Department of Neuroscience Mayo Clinic Jacksonville Florida USA
                [13 ] Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute Keck School of Medicine of USC Los Angeles California USA
                [14 ] Banner Sun Health Research Institute Sun City Arizona USA
                [15 ] Department of Neurology Mayo Clinic in Florida Jacksonville Florida USA
                [16 ] Wien Center for Alzheimer's Disease and Memory Disorders Mount Sinai Medical Center Miami Florida USA
                [17 ] Taub Institute and Department of Neurology Columbia University Irving Medical Center New York New York USA
                [18 ] Department of Neurology Mayo Clinic Rochester Minnesota USA
                [19 ] Nantz National Alzheimer Center Houston Methodist and Weill Cornell Medicine Houston Texas USA
                [20 ] Department of Neurology David Geffen School of Medicine at UCLA Los Angeles California USA
                [21 ] Department of Neurology Washington University in St. Louis St. Louis Missouri USA
                [22 ] Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USA
                [23 ] Department of Neurology, Alpert Medical School Brown University Providence Rhode Island USA
                [24 ] Department of Psychiatry and Behavioral Sciences, Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine Northwestern University Chicago Illinois USA
                [25 ] Department of Neurology & Neurological Sciences Stanford University Palo Alto California USA
                [26 ] Department of Neurology Georgetown University Washington, D.C. USA
                [27 ] Department of Neurology and Human Genetics Emory University School of Medicine Atlanta Georgia USA
                [28 ] Department of Neurology, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
                [29 ] Department of Radiology and Imaging Sciences, Center for Neuroimaging Indiana University School of Medicine Indianapolis Indianapolis Indiana USA
                Article
                10.1002/alz.13466
                37850549
                62844c86-11cb-4b5a-b09d-bbb15ab03112
                © 2023

                http://creativecommons.org/licenses/by-nc-nd/4.0/

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