European Radiology:人工智能影像学参数在预测阿尔茨海默症患者细微认知衰退中的作用

2022-09-12 shaosai MedSci原创

阿尔茨海默病相似性萎缩指数(AD-RAI)是一个基于人工智能的影像学指标,来自于3DT1脑部MRI容积,是评估阿尔茨海默症的一项重要指标。

现阶段利用磁共振(MR)神经影像学预测随后的认知能力下降是阿尔茨海默病(AD)研究中的一个主要问题。临床常规中已经提出了一些神经影像标志物,包括使用半定量视觉阅读中颞部萎缩(MTA)评分评估的海马萎缩、使用Fazekas评分评估的T2w高信号白质病变(WML)以及社区和医院队列中皮质微出血(CMB)的数量。

虽然这些经典的MR标志物在已经出现认知衰退的患者中的诊断性能已经得到证实,但它们在预测健康老年人细微的认知衰退方面的价值仍然存在争议。MTA、皮质微出血和WML都被认为会影响轻度认知障碍(MCI)前期的认知表现。然而,许多研究结果互相矛盾。这就提出了一个问题:最近提出的人工智能(AI)MR成像标志物在预测健康老年对照组的后续认知能力下降方面是否有附加价值。阿尔茨海默病相似性萎缩指数(AD-RAI)是一个基于人工智能的指标,来自于3DT1脑部MRI容积。从一个完全不同的角度来看,脑年龄差距估计(BrainAGE)得分是基于机器学习的回归任务,并被提出来捕捉与正常大脑老化的偏差。

近日,发表在European Radiology杂志的一项研究评估了基于人工智能参数AD-RAI、BrainAGE和NPH指数与既定的视觉成像标志物(MTA、Fazekas和CMB数量)相比,在预测健康老年人早期认知能力下降方面的附加价值。

本项前瞻性研究纳入了80人(46名女性,平均年龄73.4±3.5岁)。基线时进行了3T MR成像,在基线和4.5年随访时进行了广泛的神经心理学评估。基于人工智能的体积分数由3DT1得出。记录了阿尔茨海默病相似萎缩指数(AD-RAI)、脑年龄差距估计(BrainAGE)和正常压力脑积水(NPH)指数,分析包括认知分数和成像标志物之间的回归模型。 

基线的AD-RAI评分与Corsi(视觉空间记忆)的下降有关(在多元回归模型中占认知变异的10.6%)。在同时纳入MTA、CMB和Fazekas分数后,AD-RAI分数仍然是认知结果的唯一有效预测因素,解释了其变异性的16.7%。当淀粉样蛋白阳性被认为是一个额外的解释因素时,其百分比达到21.4%。BrainAGE评分与Trail Making B(执行功能)下降有关(占认知变异性的8.5%)。在传统的MRI标志物中,只有基线时的Fazekas评分与认知结果呈正相关(占认知变异性的8.7%)。增加BrainAGE评分作为独立变量后,回归模型所解释的认知变异性的百分比明显增加(从8.7%增加到14%)。淀粉样蛋白阳性的加入导致这一比例进一步增加,达到21.8%。 


 Trail Making B评分的ROC曲线下的区域。模型1(开放的方形):单独的BrainAGE;模型2(开放的圆圈):MRI变量没有BrainAGE和淀粉样蛋白阳性;模型3(开放三角形):MRI变量无淀粉样蛋白阳性;模型4(填充圆圈):所有变量

本研究表明,基于人工智能的AD-RAI指数和BrainAGE评分在预测老年对照组随后的认知能力下降方面具有显著的附加价值。

原文出处:

Panteleimon Giannakopoulos,Marie-Louise Montandon,François R Herrmann,et al.Alzheimer resemblance atrophy index, BrainAGE, and normal pressure hydrocephalus score in the prediction of subtle cognitive decline: added value compared to existing MR imaging markers.DOI:10.1007/s00330-022-08798-0

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JAMA子刊:高度依从地中海饮食模式,与更高的认知能力、更少的学习能力和记忆下降有关,即坚持地中海饮食可能会降低人群认知能力下降以及阿尔茨海默症风险。

越吃越傻!这类食物摄入每增加10%,痴呆风险增加25%

超加工食品往往是高糖、高脂、高纳、高能量,很容易诱发炎症反应,加速大脑的神经衰退和血管病变。并且,食品在多次加工的过程中,可能会存在某些危害健康的物质,从而引发脑损伤,影响人的认知功能。

JAD:草莓竟可以抵御阿尔茨海默症!

草莓中生物活性物质天竺葵素的摄入较高与AD神经病理学较少有关,主要是磷酸化的tau缠结。

Nature子刊:人工智能为帕金森病的诊断提供了数字生物标志物

该领域的研究人员已发现了一些潜在的帕金森病生物标志物,像脑脊液、血液生化和神经影像学都具有良好的检测潜力。

1包薯片就能影响大脑!超7万人研究:超加工食物摄入每增加10%,痴呆风险增加25%!

Neurology:较高的超加工食物摄入与较高的痴呆风险之间存在正相关性。具体来说,超加工食物的日均摄入量每增加10%,罹患全因痴呆症的风险也会随之增加25%(阿尔茨海默症14%,血管性痴呆28%)。