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Brain Imaging (MRI/PET) and Measurements of Proteins in Spinal Fluid May Improve Alzheimer's Prediction and Diagnosis
Date:7/14/2009

sed statistical methods to identify the best set of predictors that correctly identified (a) healthy people versus those with Alzheimer's, and (b) people with mild cognitive impairment (MCI) who progressed to Alzheimer's (of which there were 50 people in the study who converted over the next year and a half).

"The clinical symptoms of MCI alone are not enough to allow for early diagnosis of Alzheimer's," Ewers said. "In fact, a substantial proportion of people with MCI may revert back to normal or may not develop Alzheimer's for years. Thus, the challenging task is to discern which of people with MCI have the Alzheimer's brain changes that may be responsible for their initial memory and thinking problems and their eventual progression to Alzheimer's, so that they can be targeted for Alzheimer's-specific treatments."

The researchers found that results of three subunits of the memory tests could be combined to reach a classification accuracy of 89.9% for distinguishing people who progressed from MCI to Alzheimer's versus healthy people. They found that by adding in results from MRI volume measurements of the left hippocampus - a brain region closely linked to memory and Alzheimer's - they could increase classification accuracy to 94%. When, as a means to validate the findings, the same set of tests and measures was applied to distinguish the healthy people from those with Alzheimer's, classification accuracy was 95.7%.

When the researchers also included measures of tau and beta amyloid in CSF and presence or absence of a known Alzheimer's risk genotype (ApoE-e4), they could correctly identify people with MCI who progressed to Alzheimer's within 1.5 years with 95.6% accuracy, but the model including only memory tests plus hippocampus was the most robust predictor set.

"Our results show that a relatively simple prediction model, including the combination of hippocampus volume measured by
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SOURCE Alzheimer's Association
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