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Romano MF, Zhou X, Balachandra AR, Jadick MF, Qiu S, Nijhawan DA, Joshi PS, Mohammad S, Lee PH, Smith MJ, Paul AB, Mian AZ, Small JE, Chin SP, Au R, Kolachalama VB. Deep learning for risk-based stratification of cognitively impaired individuals. iScience 2023; 26:107522. [PMID: 37646016 PMCID: PMC10460987 DOI: 10.1016/j.isci.2023.107522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/19/2023] [Accepted: 07/28/2023] [Indexed: 09/01/2023] Open
Abstract
Quantifying the risk of progression to Alzheimer's disease (AD) could help identify persons who could benefit from early interventions. We used data from the Alzheimer's Disease Neuroimaging Initiative (ADNI, n = 544, discovery cohort) and the National Alzheimer's Coordinating Center (NACC, n = 508, validation cohort), subdividing individuals with mild cognitive impairment (MCI) into risk groups based on cerebrospinal fluid amyloid-β levels and identifying differential gray matter patterns. We then created models that fused neural networks with survival analysis, trained using non-parcellated T1-weighted brain MRIs from ADNI data, to predict the trajectories of MCI to AD conversion within the NACC cohort (integrated Brier score: 0.192 [discovery], and 0.108 [validation]). Using modern interpretability techniques, we verified that regions important for model prediction are classically associated with AD. We confirmed AD diagnosis labels using postmortem data. We conclude that our framework provides a strategy for risk-based stratification of individuals with MCI and for identifying regions key for disease prognosis.
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Affiliation(s)
- Michael F. Romano
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Xiao Zhou
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Computer Science, Boston University, Boston, MA, USA
| | - Akshara R. Balachandra
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Michalina F. Jadick
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Shangran Qiu
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Diya A. Nijhawan
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Prajakta S. Joshi
- Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of General Dentistry, Boston University School of Dental Medicine, Boston, MA, USA
- The Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Shariq Mohammad
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Peter H. Lee
- Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | - Maximilian J. Smith
- Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | - Aaron B. Paul
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Asim Z. Mian
- Department of Radiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Juan E. Small
- Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | - Sang P. Chin
- Department of Computer Science, Boston University, Boston, MA, USA
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
- Center of Mathematical Sciences & Applications, Harvard University, Cambridge, MA, USA
| | - Rhoda Au
- Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- The Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Boston University Alzheimer’s Disease Research Center, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Vijaya B. Kolachalama
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Computer Science, Boston University, Boston, MA, USA
- Boston University Alzheimer’s Disease Research Center, Boston, MA, USA
- Faculty of Computing & Data Sciences, Boston University, Boston, MA, USA
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Hatton SN, Huynh KH, Bonilha L, Abela E, Alhusaini S, Altmann A, Alvim MKM, Balachandra AR, Bartolini E, Bender B, Bernasconi N, Bernasconi A, Bernhardt B, Bargallo N, Caldairou B, Caligiuri ME, Carr SJA, Cavalleri GL, Cendes F, Concha L, Davoodi-bojd E, Desmond PM, Devinsky O, Doherty CP, Domin M, Duncan JS, Focke NK, Foley SF, Gambardella A, Gleichgerrcht E, Guerrini R, Hamandi K, Ishikawa A, Keller SS, Kochunov PV, Kotikalapudi R, Kreilkamp BAK, Kwan P, Labate A, Langner S, Lenge M, Liu M, Lui E, Martin P, Mascalchi M, Moreira JCV, Morita-Sherman ME, O’Brien TJ, Pardoe HR, Pariente JC, Ribeiro LF, Richardson MP, Rocha CS, Rodríguez-Cruces R, Rosenow F, Severino M, Sinclair B, Soltanian-Zadeh H, Striano P, Taylor PN, Thomas RH, Tortora D, Velakoulis D, Vezzani A, Vivash L, von Podewils F, Vos SB, Weber B, Winston GP, Yasuda CL, Zhu AH, Thompson PM, Whelan CD, Jahanshad N, Sisodiya SM, McDonald CR. White matter abnormalities across different epilepsy syndromes in adults: an ENIGMA-Epilepsy study. Brain 2020; 143:2454-2473. [PMID: 32814957 PMCID: PMC7567169 DOI: 10.1093/brain/awaa200] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/07/2020] [Accepted: 04/30/2020] [Indexed: 12/22/2022] Open
Abstract
The epilepsies are commonly accompanied by widespread abnormalities in cerebral white matter. ENIGMA-Epilepsy is a large quantitative brain imaging consortium, aggregating data to investigate patterns of neuroimaging abnormalities in common epilepsy syndromes, including temporal lobe epilepsy, extratemporal epilepsy, and genetic generalized epilepsy. Our goal was to rank the most robust white matter microstructural differences across and within syndromes in a multicentre sample of adult epilepsy patients. Diffusion-weighted MRI data were analysed from 1069 healthy controls and 1249 patients: temporal lobe epilepsy with hippocampal sclerosis (n = 599), temporal lobe epilepsy with normal MRI (n = 275), genetic generalized epilepsy (n = 182) and non-lesional extratemporal epilepsy (n = 193). A harmonized protocol using tract-based spatial statistics was used to derive skeletonized maps of fractional anisotropy and mean diffusivity for each participant, and fibre tracts were segmented using a diffusion MRI atlas. Data were harmonized to correct for scanner-specific variations in diffusion measures using a batch-effect correction tool (ComBat). Analyses of covariance, adjusting for age and sex, examined differences between each epilepsy syndrome and controls for each white matter tract (Bonferroni corrected at P < 0.001). Across 'all epilepsies' lower fractional anisotropy was observed in most fibre tracts with small to medium effect sizes, especially in the corpus callosum, cingulum and external capsule. There were also less robust increases in mean diffusivity. Syndrome-specific fractional anisotropy and mean diffusivity differences were most pronounced in patients with hippocampal sclerosis in the ipsilateral parahippocampal cingulum and external capsule, with smaller effects across most other tracts. Individuals with temporal lobe epilepsy and normal MRI showed a similar pattern of greater ipsilateral than contralateral abnormalities, but less marked than those in patients with hippocampal sclerosis. Patients with generalized and extratemporal epilepsies had pronounced reductions in fractional anisotropy in the corpus callosum, corona radiata and external capsule, and increased mean diffusivity of the anterior corona radiata. Earlier age of seizure onset and longer disease duration were associated with a greater extent of diffusion abnormalities in patients with hippocampal sclerosis. We demonstrate microstructural abnormalities across major association, commissural, and projection fibres in a large multicentre study of epilepsy. Overall, patients with epilepsy showed white matter abnormalities in the corpus callosum, cingulum and external capsule, with differing severity across epilepsy syndromes. These data further define the spectrum of white matter abnormalities in common epilepsy syndromes, yielding more detailed insights into pathological substrates that may explain cognitive and psychiatric co-morbidities and be used to guide biomarker studies of treatment outcomes and/or genetic research.
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Affiliation(s)
- Sean N Hatton
- Department of Neurosciences, Center for Multimodal Imaging and Genetics,
University of California San Diego, La Jolla 92093 CA, USA
| | - Khoa H Huynh
- Center for Multimodal Imaging and Genetics, University of California San
Diego, La Jolla 92093 CA, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina,
Charleston 29425 SC, USA
| | - Eugenio Abela
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry,
Psychology and Neuroscience, Kings College London, London SE5 9NU UK
| | - Saud Alhusaini
- Neurology Department, Yale School of Medicine, New Haven 6510 CT,
USA
- Molecular and Cellular Therapeutics, The Royal College of Surgeons in
Ireland, Dublin, Ireland
| | - Andre Altmann
- Centre of Medical Image Computing, Department of Medical Physics and Biomedical
Engineering, University College London, London WC1V 6LJ, UK
| | - Marina K M Alvim
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Akshara R Balachandra
- Center for Multimodal Imaging and Genetics, UCSD School of
Medicine, La Jolla 92037 CA, USA
- Boston University School of Medicine, Boston 2118 MA, USA
| | - Emanuele Bartolini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories,
Children’s Hospital A. Meyer-University of Florence, Florence, Italy
- USL Centro Toscana, Neurology Unit, Nuovo Ospedale Santo Stefano,
Prato, Italy
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University Hospital
Tübingen, Tübingen 72076, Germany
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill
University, Montreal H3A 2B4 QC, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill
University, Montreal H3A 2B4 QC, Canada
| | - Boris Bernhardt
- Montreal Neurological Institute, McGill University, Montreal
H3A2B4 QC, Canada
| | - Núria Bargallo
- Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques
August Pi i Sunyer (IDIBAPS), Barcelona 8036 Barcelona, Spain
| | - Benoit Caldairou
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill
University, Montreal H3A 2B4 QC, Canada
| | - Maria E Caligiuri
- Neuroscience Research Center, University Magna Graecia, viale Europa,
Germaneto, 88100, Catanzaro, Italy
| | - Sarah J A Carr
- Neuroscience, Institute of Psychiatry, Psychology and
Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Gianpiero L Cavalleri
- Royal College of Surgeons in Ireland, School of Pharmacy and Biomolecular
Sciences, Dublin D02 YN77 Ireland
- FutureNeuro Research Centre, Science Foundation Ireland, Dublin
D02 YN77, Ireland
| | - Fernando Cendes
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Luis Concha
- Institute of Neurobiology, Universidad Nacional Autonoma de
Mexico, Queretaro 76230, Mexico
| | - Esmaeil Davoodi-bojd
- Radiology and Research Administration, Henry Ford Hospital, 1
Detroit 48202 MI, USA
| | - Patricia M Desmond
- Department of Radiology, Royal Melbourne Hospital, University of
Melbourne, Melbourne 3050 Victoria, Australia
| | | | - Colin P Doherty
- Division of Neurology, Trinity College Dublin, TBSI, Pearce
Street, Dublin D02 R590, Ireland
- FutureNeuro SFI Centre for Neurological Disease, RCSI, St Stephen’s
Green, Dublin D02 H903, Ireland
| | - Martin Domin
- Functional Imaging Unit, University Medicine Greifswald,
Greifswald 17475 M/V, Germany
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of
Neurology, Queen Square, London WC1N 3BG, UK
- MRI Unit, Chalfont Centre for Epilepsy, Chalfont-St-Peter,
Buckinghamshire SL9 0RJ, UK
| | - Niels K Focke
- Clinical Neurophysiology, University Medicine Göttingen, 37099
Göttingen, Germany
- Department of Epileptology, University of Tübingen, 72076
Tübingen, Germany
| | | | - Antonio Gambardella
- Royal College of Surgeons in Ireland, School of Pharmacy and Biomolecular
Sciences, Dublin D02 YN77 Ireland
- Institute of Neurology, University Magna Graecia, 88100,
Catanzaro, Italy
| | | | - Renzo Guerrini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories,
Children’s Hospital A. Meyer-University of Florence, Florence, Italy
| | - Khalid Hamandi
- The Wales Epilepsy Unit, Cardiff and Vale University Health
Board, Cardiff CF144XW, UK
- Brain Research Imaging Centre, Cardiff University, Cardiff CF24
4HQ, UK
| | - Akari Ishikawa
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Simon S Keller
- Institute of Translational Medicine, University of Liverpool,
Liverpool L69 3BX, UK
- Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, UK
| | - Peter V Kochunov
- Maryland Psychiatric Research Center, 55 Wade Ave, Baltimore
21228, MD, USA
| | - Raviteja Kotikalapudi
- Department of Neurology and Epileptology, University Hospital
Tübingen, Tübingen 72076 BW, Germany
- Department of Diagnostic and Interventional Neuroradiology, University Hospital
Tübingen, Tübingen 72076 BW, Germany
| | - Barbara A K Kreilkamp
- Institute of Translational Medicine, University of Liverpool,
Liverpool L69 3BX, UK
- Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, UK
| | - Patrick Kwan
- Department of Neuroscience, Central Clinical School, Monash
University, Melbourne 3004 Victoria, Australia
- Department of Medicine, University of Melbourne, Royal Melbourne
Hospital, Parkville 3050 Victoria, Australia
| | - Angelo Labate
- Neuroscience Research Center, University Magna Graecia, viale Europa,
Germaneto, 88100, Catanzaro, Italy
- Institute of Neurology, University Magna Graecia, 88100,
Catanzaro, Italy
| | - Soenke Langner
- Institute for Diagnostic Radiology and Neuroradiology, Ernst Moritz Arndt
University Greifswald Faculty of Medicine, Greifswald 17475, Germany
- Institute for Diagnostic and Interventional Radiology, Pediatric and
Neuroradiology, Rostock University Medical Centre, Rostock 18057, Germany
| | - Matteo Lenge
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories,
Children’s Hospital A. Meyer-University of Florence, Florence, Italy
- Functional and Epilepsy Neurosurgery Unit, Children’s Hospital A.
Meyer-University of Florence, Florence 50139, Italy
| | - Min Liu
- Department of Neurology, Montreal Neurological Institute,
Montreal H3A 2B4 QC, Canada
| | - Elaine Lui
- Department of Radiology, Royal Melbourne Hospital, University of
Melbourne, Melbourne 3050 Victoria, Australia
- Department of Medicine and Radiology, University of Melbourne,
3Parkville 3050 Victoria, Australia
| | - Pascal Martin
- Department of Epileptology, University of Tübingen, 72076
Tübingen, Germany
| | - Mario Mascalchi
- Meyer Children Hospital University of Florence, Florence 50130
Tuscany, Italy
| | - José C V Moreira
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Marcia E Morita-Sherman
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
- Cleveland Clinic, Cleveland 44195 OH, USA
| | - Terence J O’Brien
- Department of Neuroscience, Central Clinical School, Monash
University, Melbourne 3004 Victoria, Australia
- Department of Medicine, University of Melbourne, Royal Melbourne
Hospital, Parkville 3050 Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne 3004 Victoria,
Australia
| | - Heath R Pardoe
- Department of Neurology, New York University School of Medicine,
New York City 10016 NY, USA
| | - José C Pariente
- Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques
August Pi i Sunyer (IDIBAPS), Barcelona 8036 Barcelona, Spain
| | - Letícia F Ribeiro
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Mark P Richardson
- Division of Neuroscience, King’s College London, Institute of
Psychiatry, London SE5 8AB, UK
| | - Cristiane S Rocha
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Raúl Rodríguez-Cruces
- Montreal Neurological Institute, McGill University, Montreal
H3A2B4 QC, Canada
- Institute of Neurobiology, Universidad Nacional Autonoma de
Mexico, Queretaro 76230, Mexico
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt,
Germany, Frankfurt 60528 Hesse, Germany
- Center for Personalized Translational Epilepsy Research (CePTER),
Goethe-University Frankfurt, Frankfurt a. M. 60528, Germany
| | - Mariasavina Severino
- Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa 16147
Liguria, Italy
| | - Benjamin Sinclair
- Department of Medicine, University of Melbourne, Royal Melbourne
Hospital, Parkville 3050 Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne 3004 Victoria,
Australia
| | - Hamid Soltanian-Zadeh
- Radiology and Research Administration, Henry Ford Health System,
Detroit 48202-2692 MI, USA
- School of Electrical and Computer Engineering, University of
Tehran, Tehran 14399-57131, Iran
| | - Pasquale Striano
- IRCCS Istituto Giannina Gaslini, Genoa 16147 Liguria, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal
and Child Health, University of Genova, Genova, Italy
| | - Peter N Taylor
- School of Computing, Newcastle University, Urban Sciences Building, Science
Square, Newcastle upon Tyne NE4 5TG, UK
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Newcastle
University, Newcastle upon Tyne NE2 4HH, UK
- Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK
| | - Domenico Tortora
- Radiology and Research Administration, Henry Ford Health System,
Detroit 48202-2692 MI, USA
| | - Dennis Velakoulis
- Royal Melbourne Hospital, Melbourne 3050 Victoria, Australia
- University of Melbourne, Parkville, Melbourne 3050 Victoria,
Australia
| | - Annamaria Vezzani
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano
20156 Italy
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Monash
University, Melbourne 3004 Victoria, Australia
- Department of Medicine, University of Melbourne, Royal Melbourne
Hospital, Parkville 3050 Victoria, Australia
| | - Felix von Podewils
- Epilepsy Center, University Medicine Greifswald, Greifswald 17489
Mecklenburg-Vorpommern, Germany
| | - Sjoerd B Vos
- Centre for Medical Image Computing, University College London,
London, WC1V 6LJ, UK
- Epilepsy Society, MRI Unit, Chalfont St Peter, Buckinghamshire,
SL9 0RJ, UK
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University of
Bonn, Venusberg Campus 1, Bonn 53127 NRW, Germany
| | - Gavin P Winston
- Epilepsy Society, MRI Unit, Chalfont St Peter, Buckinghamshire,
SL9 0RJ, UK
- Department of Medicine, Division of Neurology, Queen's
University, Kingston K7L 3N6 ON, Canada
- MRI Unit, Chalfont Centre for Epilepsy, Chalfont-St-Peter,
Buckinghamshire, SL9 0RJ UK
| | - Clarissa L Yasuda
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Alyssa H Zhu
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and
Informatics, USC Keck School of Medicine, Los Angeles 90232 CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and
Informatics, USC Keck School of Medicine, Los Angeles 90232 CA, USA
| | - Christopher D Whelan
- Molecular and Cellular Therapeutics, The Royal College of Surgeons in
Ireland, Dublin, Ireland
- Research and Early Development (RED), Biogen Inc., Cambridge, MA
02139, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and
Informatics, USC Keck School of Medicine, Los Angeles 90232 CA, USA
| | - Sanjay M Sisodiya
- MRI Unit, Chalfont Centre for Epilepsy, Chalfont-St-Peter,
Buckinghamshire, SL9 0RJ UK
- Chalfont Centre for Epilepsy, Chalfont-St-Peter, SL9 0RJ Bucks,
UK
| | - Carrie R McDonald
- Department of Psychiatry, Center for Multimodal Imaging and Genetics,
University of California San Diego, La Jolla 92093 CA, USA
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3
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Balachandra AR, Kaestner E, Bahrami N, Reyes A, Lalani S, Macari AC, Paul BM, Bonilha L, McDonald CR. Clinical utility of structural connectomics in predicting memory in temporal lobe epilepsy. Neurology 2020; 94:e2424-e2435. [PMID: 32358221 PMCID: PMC7455364 DOI: 10.1212/wnl.0000000000009457] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 12/02/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the predictive power of white matter neuronal networks (i.e., structural connectomes [SCs]) in discriminating memory-impaired patients with temporal lobe epilepsy (TLE) from those with normal memory. METHODS T1- and diffusion MRI (dMRI), clinical variables, and neuropsychological measures of verbal memory were available for 81 patients with TLE. Prediction of memory impairment was performed with a tree-based classifier (XGBoost) for 4 models: (1) a clinical model including demographic and clinical features, (2) a hippocampal volume (HCV) model, (3) a tract model including 5 temporal lobe white matter association tracts derived from a dMRI atlas, and (4) an SC model based on dMRI. SCs were derived by extracting cortical-cortical connections from a temporal lobe subnetwork with probabilistic tractography. Principal component (PC) analysis was then applied to reduce the dimensionality of the SC, yielding 10 PCs. Multimodal models were also tested combining SCs and tracts with HCV. Each model was trained on 48 patients from 1 epilepsy center and tested on 33 patients from a different center. RESULTS Multimodal models that included the SC + HCV model yielded the highest classification accuracy (81%; 0.90 sensitivity; 0.67 specificity), outperforming the clinical model (61%; p < 0.001) and HCV model (66%; p < 0.001). In addition, the unimodal SC model (76% accuracy) and tract model (73% accuracy) outperformed the clinical model (p < 0.001) and HCV model (p < 0.001) for classifying patients with TLE with and without memory impairment. Furthermore, the SC identified that short-range temporal-temporal connections were important contributors to memory performance. CONCLUSION SCs and tract-based models are stronger predictors of memory impairment in TLE than HCVs and clinical variables. However, SCs may provide additional information about local cortical-cortical connectivity contributing to memory that is not captured in large association tracts.
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Affiliation(s)
- Akshara R Balachandra
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Erik Kaestner
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Naeim Bahrami
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Anny Reyes
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Sanam Lalani
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Anna Christina Macari
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Brianna M Paul
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Leonardo Bonilha
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Carrie R McDonald
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA.
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Sisodiya SM, Whelan CD, Hatton SN, Huynh K, Altmann A, Ryten M, Vezzani A, Caligiuri ME, Labate A, Gambardella A, Ives‐Deliperi V, Meletti S, Munsell BC, Bonilha L, Tondelli M, Rebsamen M, Rummel C, Vaudano AE, Wiest R, Balachandra AR, Bargalló N, Bartolini E, Bernasconi A, Bernasconi N, Bernhardt B, Caldairou B, Carr SJ, Cavalleri GL, Cendes F, Concha L, Desmond PM, Domin M, Duncan JS, Focke NK, Guerrini R, Hamandi K, Jackson GD, Jahanshad N, Kälviäinen R, Keller SS, Kochunov P, Kowalczyk MA, Kreilkamp BA, Kwan P, Lariviere S, Lenge M, Lopez SM, Martin P, Mascalchi M, Moreira JC, Morita‐Sherman ME, Pardoe HR, Pariente JC, Raviteja K, Rocha CS, Rodríguez‐Cruces R, Seeck M, Semmelroch MK, Sinclair B, Soltanian‐Zadeh H, Stein DJ, Striano P, Taylor PN, Thomas RH, Thomopoulos SI, Velakoulis D, Vivash L, Weber B, Yasuda CL, Zhang J, Thompson PM, McDonald CR. The ENIGMA-Epilepsy working group: Mapping disease from large data sets. Hum Brain Mapp 2020; 43:113-128. [PMID: 32468614 PMCID: PMC8675408 DOI: 10.1002/hbm.25037] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 02/06/2023] Open
Abstract
Epilepsy is a common and serious neurological disorder, with many different constituent conditions characterized by their electro clinical, imaging, and genetic features. MRI has been fundamental in advancing our understanding of brain processes in the epilepsies. Smaller-scale studies have identified many interesting imaging phenomena, with implications both for understanding pathophysiology and improving clinical care. Through the infrastructure and concepts now well-established by the ENIGMA Consortium, ENIGMA-Epilepsy was established to strengthen epilepsy neuroscience by greatly increasing sample sizes, leveraging ideas and methods established in other ENIGMA projects, and generating a body of collaborating scientists and clinicians to drive forward robust research. Here we review published, current, and future projects, that include structural MRI, diffusion tensor imaging (DTI), and resting state functional MRI (rsfMRI), and that employ advanced methods including structural covariance, and event-based modeling analysis. We explore age of onset- and duration-related features, as well as phenomena-specific work focusing on particular epilepsy syndromes or phenotypes, multimodal analyses focused on understanding the biology of disease progression, and deep learning approaches. We encourage groups who may be interested in participating to make contact to further grow and develop ENIGMA-Epilepsy.
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Affiliation(s)
- Sanjay M. Sisodiya
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Chalfont Centre for EpilepsyBucksUK
| | - Christopher D. Whelan
- Department of Molecular and Cellular TherapeuticsThe Royal College of Surgeons in IrelandDublinIreland
| | - Sean N. Hatton
- Center for Multimodal Imaging and GeneticsUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Khoa Huynh
- Center for Multimodal Imaging and GeneticsUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Andre Altmann
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Mina Ryten
- UCL Queen Square Institute of NeurologyLondonUK
| | - Annamaria Vezzani
- Department of NeuroscienceIstituto di Ricerche Farmacologiche Mario Negri IRCCSMilanItaly
| | - Maria Eugenia Caligiuri
- Neuroscience Research Center, Department of Medical and Surgical SciencesUniversity “Magna Græcia" of CatanzaroCatanzaroItaly
| | - Angelo Labate
- Neuroscience Research Center, Department of Medical and Surgical SciencesUniversity “Magna Græcia" of CatanzaroCatanzaroItaly
- Institute of NeurologyUniversity “Magna Græcia" of CatanzaroCatanzaroItaly
| | - Antonio Gambardella
- Neuroscience Research Center, Department of Medical and Surgical SciencesUniversity “Magna Græcia" of CatanzaroCatanzaroItaly
- Institute of NeurologyUniversity “Magna Græcia" of CatanzaroCatanzaroItaly
| | | | - Stefano Meletti
- Department of Biomedical, Metabolic, and Neural SciencesUniversity of Modena and Reggio EmiliaModenaItaly
- Neurology UnitOCB Hospital, AOU ModenaModenaItaly
| | - Brent C. Munsell
- Department of PsychiatryUniversity of North CarolinaChapel HillNorth CarolinaUSA
- Department of Computer ScienceUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Leonardo Bonilha
- Department of NeurologyMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | | | - Michael Rebsamen
- Support Center for Advanced NeuroimagingUniversity Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of BernBernSwitzerland
| | - Christian Rummel
- Support Center for Advanced NeuroimagingUniversity Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of BernBernSwitzerland
| | - Anna Elisabetta Vaudano
- Department of Biomedical, Metabolic, and Neural SciencesUniversity of Modena and Reggio EmiliaModenaItaly
- Neurology UnitOCB Hospital, AOU ModenaModenaItaly
| | - Roland Wiest
- Support Center for Advanced NeuroimagingUniversity Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of BernBernSwitzerland
| | - Akshara R. Balachandra
- Center for Multimodal Imaging and GeneticsUniversity of California San DiegoLa JollaCaliforniaUSA
- Boston University School of MedicineBostonMassachusettsUSA
| | - Núria Bargalló
- Magnetic Resonance Image Core FacilityInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de BarcelonaBarcelonaSpain
- Radiology Department of Center of Image DiagnosisHospital Clinic de BarcelonaBarcelonaSpain
| | - Emanuele Bartolini
- Neurology UnitUSL Centro Toscana, Nuovo Ospedale Santo StefanoPratoItaly
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy LaboratoryMontreal Neurological Institute, McGill UniversityMontrealQuébecCanada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy LaboratoryMontreal Neurological Institute, McGill UniversityMontrealQuébecCanada
| | - Boris Bernhardt
- McConnell Brain Imaging CenterMontreal Neurological Institute, McGill UniversityMontrealQuébecCanada
| | - Benoit Caldairou
- Neuroimaging of Epilepsy LaboratoryMontreal Neurological Institute, McGill UniversityMontrealQuébecCanada
| | - Sarah J.A. Carr
- NeuroscienceInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
| | - Gianpiero L. Cavalleri
- School of Pharmacy and Biomolecular SciencesThe Royal College of Surgeons in IrelandDublinIreland
- FutureNeuro SFI Research CentreDublinIreland
| | - Fernando Cendes
- Department of Neurology and Neuroimaging LaboratoryUniversity of Campinas – UNICAMPCampinasSão PauloBrazil
| | - Luis Concha
- Instituto de NeurobiologíaUniversidad Nacional Autónoma de MéxicoQuerétaroMexico
| | - Patricia M. Desmond
- Department of RadiologyRoyal Melbourne Hospital, University of MelbourneMelbourneVictoriaAustralia
| | - Martin Domin
- Functional Imaging Unit, Department of Diagnostic Radiology and NeuroradiologyUniversity Medicine GreifswaldGreifswaldGermany
| | - John S. Duncan
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Chalfont Centre for EpilepsyBucksUK
| | - Niels K. Focke
- University Medicine GöttingenClinical NeurophysiologyGöttingenGermany
| | - Renzo Guerrini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and LaboratoriesChildren's Hospital A. Meyer‐University of FlorenceFlorenceItaly
| | - Khalid Hamandi
- The Wales Epilepsy Unit, Department of NeurologyUniversity Hospital of WalesCardiffUK
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUK
| | - Graeme D. Jackson
- Department of NeurologyAustin HealthHeidelbergVictoriaAustralia
- Florey Department of Neuroscience and Mental HealthUniversity of MelbourneVictoriaAustralia
| | - Neda Jahanshad
- Imaging Genetics CenterMark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Reetta Kälviäinen
- Kuopio University HospitalMember of EpiCARE ERNKuopioFinland
- Institute of Clinical MedicineNeurology, University of Eastern FinlandKuopioFinland
| | - Simon S. Keller
- Institute of Systems, Molecular and Integrative BiologyUniversity of LiverpoolLiverpoolUK
- The Walton CentreNHS Foundation TrustLiverpoolUK
| | - Peter Kochunov
- Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Magdalena A. Kowalczyk
- Florey Department of Neuroscience and Mental HealthUniversity of MelbourneVictoriaAustralia
| | - Barbara A.K. Kreilkamp
- Institute of Systems, Molecular and Integrative BiologyUniversity of LiverpoolLiverpoolUK
- The Walton CentreNHS Foundation TrustLiverpoolUK
| | - Patrick Kwan
- Department of Neuroscience, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - Sara Lariviere
- McConnell Brain Imaging CenterMontreal Neurological Institute, McGill UniversityMontrealQuébecCanada
| | - Matteo Lenge
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and LaboratoriesChildren's Hospital A. Meyer‐University of FlorenceFlorenceItaly
- Functional and Epilepsy Neurosurgery Unit, Neurosurgery DepartmentChildren's Hospital A. Meyer‐University of FlorenceFlorenceItaly
| | - Seymour M. Lopez
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Pascal Martin
- Department of Neurology and EpileptologyHertie Institute for Clinical Brain Research, University Hospital TübingenTübingenGermany
| | - Mario Mascalchi
- 'Mario Serio' Department of Clinical and Experimental Medical SciencesUniversity of FlorenceFlorenceItaly
| | - José C.V. Moreira
- Department of Neurology and Neuroimaging LaboratoryUniversity of Campinas – UNICAMPCampinasSão PauloBrazil
| | - Marcia E. Morita‐Sherman
- Department of Neurology and Neuroimaging LaboratoryUniversity of Campinas – UNICAMPCampinasSão PauloBrazil
- Cleveland Clinic Neurological InstituteClevelandOhioUSA
| | - Heath R. Pardoe
- Department of NeurologyNew York University School of MedicineNew YorkNew YorkUSA
| | - Jose C. Pariente
- Magnetic Resonance Image Core FacilityInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de BarcelonaBarcelonaSpain
| | - Kotikalapudi Raviteja
- Department of Neurology and EpileptologyHertie Institute for Clinical Brain Research, University Hospital TübingenTübingenGermany
- Department of Diagnostic and Interventional NeuroradiologyUniversity Hospitals TübingenTübingenGermany
- Department of Clinical NeurophysiologyUniversity Hospital GöttingenGoettingenGermany
| | - Cristiane S. Rocha
- Department of Neurology and Neuroimaging LaboratoryUniversity of Campinas – UNICAMPCampinasSão PauloBrazil
| | - Raúl Rodríguez‐Cruces
- Instituto de NeurobiologíaUniversidad Nacional Autónoma de MéxicoQuerétaroMexico
- Montreal Neurological Institute and HospitalMcGill UniversityMontrealQuébecCanada
| | | | - Mira K.H.G. Semmelroch
- Florey Department of Neuroscience and Mental HealthUniversity of MelbourneVictoriaAustralia
- The Florey Institute of Neuroscience and Mental HealthAustin CampusHeidelbergVictoriaAustralia
| | - Benjamin Sinclair
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
- Alfred HealthMelbourneVictoriaAustralia
| | - Hamid Soltanian‐Zadeh
- Radiology and Research AdministrationHenry Ford Health SystemDetroitMichiganUSA
- School of Electrical and Computer EngineeringCollege of Engineering, University of TehranTehranIran
| | - Dan J. Stein
- South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience InstituteUniversity of Cape Townon Risk & Resilience in Mental DisordersCape TownSouth Africa
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases UnitIRCCS Istituto 'G. Gaslini'GenovaItaly
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child HealthUniversity of GenovaItaly
| | - Peter N. Taylor
- School of ComputingNewcastle UniversityNewcastle upon TyneUK
| | - Rhys H. Thomas
- Institute of Translational and Clinical ResearchNewcastle UniversityNewcastle upon TyneUK
| | - Sophia I. Thomopoulos
- Imaging Genetics CenterMark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Dennis Velakoulis
- Department of Medicine, Royal Melbourne HospitalUniversity of MelbourneParkvilleVictoriaUK
- Department of NeuropsychiatryRoyal Melbourne HospitalParkvilleVictoriaAustralia
| | - Lucy Vivash
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyRoyal Melbourne HospitalMelbourneVictoriaAustralia
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition ResearchUniversity of BonnBonnGermany
| | - Clarissa Lin Yasuda
- Department of Neurology and Neuroimaging LaboratoryUniversity of Campinas – UNICAMPCampinasSão PauloBrazil
| | - Junsong Zhang
- Cognitive Science DepartmentSchool of Informatics, Xiamen UniversityXiamenChina
| | - Paul M. Thompson
- Imaging Genetics CenterMark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Carrie R. McDonald
- Department of PsychiatryUniversity of California San DiegoLa JollaCaliforniaUSA
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Kaestner E, Balachandra AR, Bahrami N, Reyes A, Lalani SJ, Macari AC, Voets NL, Drane DL, Paul BM, Bonilha L, McDonald CR. The white matter connectome as an individualized biomarker of language impairment in temporal lobe epilepsy. Neuroimage Clin 2019; 25:102125. [PMID: 31927128 PMCID: PMC6953962 DOI: 10.1016/j.nicl.2019.102125] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/10/2019] [Accepted: 12/13/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The distributed white matter network underlying language leads to difficulties in extracting clinically meaningful summaries of neural alterations leading to language impairment. Here we determine the predictive ability of the structural connectome (SC), compared with global measures of white matter tract microstructure and clinical data, to discriminate language impaired patients with temporal lobe epilepsy (TLE) from TLE patients without language impairment. METHODS T1- and diffusion-MRI, clinical variables (CVs), and neuropsychological measures of naming and verbal fluency were available for 82 TLE patients. Prediction of language impairment was performed using a robust tree-based classifier (XGBoost) for three models: (1) a CV-model which included demographic and epilepsy-related clinical features, (2) an atlas-based tract-model, including four frontotemporal white matter association tracts implicated in language (i.e., the bilateral arcuate fasciculus, inferior frontal occipital fasciculus, inferior longitudinal fasciculus, and uncinate fasciculus), and (3) a SC-model based on diffusion MRI. For the association tracts, mean fractional anisotropy was calculated as a measure of white matter microstructure for each tract using a diffusion tensor atlas (i.e., AtlasTrack). The SC-model used measurement of cortical-cortical connections arising from a temporal lobe subnetwork derived using probabilistic tractography. Dimensionality reduction of the SC was performed with principal components analysis (PCA). Each model was trained on 49 patients from one epilepsy center and tested on 33 patients from a different center (i.e., an independent dataset). Randomization was performed to test the stability of the results. RESULTS The SC-model yielded a greater area under the curve (AUC; .73) and accuracy (79%) compared to both the tract-model (AUC: .54, p < .001; accuracy: 70%, p < .001) and the CV-model (AUC: .59, p < .001; accuracy: 64%, p < .001). Within the SC-model, lateral temporal connections had the highest importance to model performance, including connections similar to language association tracts such as links between the superior temporal gyrus to pars opercularis. However, in addition to these connections many additional connections that were widely distributed, bilateral and interhemispheric in nature were identified as contributing to SC-model performance. CONCLUSION The SC revealed a white matter network contributing to language impairment that was widely distributed, bilateral, and lateral temporal in nature. The distributed network underlying language may be why the SC-model has an advantage in identifying sub-components of the complex fiber networks most relevant for aspects of language performance.
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Affiliation(s)
- Erik Kaestner
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Akshara R Balachandra
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Naeim Bahrami
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Anny Reyes
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Sanam J Lalani
- Department of Neurology, University of California - San Francisco, San Francisco, CA, USA
| | - Anna Christina Macari
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Natalie L Voets
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Daniel L Drane
- Departments of Neurology and Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, University of Washington, Seattle, WA, USA
| | - Brianna M Paul
- Department of Neurology, University of California - San Francisco, San Francisco, CA, USA
| | - Leonardo Bonilha
- Medical University of South Carolina, Department of Neurology, USA
| | - Carrie R McDonald
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA.
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6
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Reas ET, Hagler DJ, White NS, Kuperman JM, Bartsch H, Cross K, Loi RQ, Balachandra AR, Meloy MJ, Wierenga CE, Galasko D, Brewer JB, Dale AM, McEvoy LK. Sensitivity of restriction spectrum imaging to memory and neuropathology in Alzheimer's disease. Alzheimers Res Ther 2017; 9:55. [PMID: 28764771 PMCID: PMC5539622 DOI: 10.1186/s13195-017-0281-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 06/27/2017] [Indexed: 11/24/2022]
Abstract
Background Diffusion imaging has demonstrated sensitivity to structural brain changes in Alzheimer’s disease (AD). However, there remains a need for a more complete characterization of microstructural alterations occurring at the earliest disease stages, and how these changes relate to underlying neuropathology. This study evaluated the sensitivity of restriction spectrum imaging (RSI), an advanced diffusion magnetic resonance imaging (MRI) technique, to microstructural brain changes in mild cognitive impairment (MCI) and AD. Methods MRI and neuropsychological test data were acquired from 31 healthy controls, 12 individuals with MCI, and 13 individuals with mild AD, aged 63–93 years. Cerebrospinal fluid amyloid-β levels were measured in a subset (n = 38) of participants. RSI measures of neurite density (ND) and isotropic free water (IF) were computed in fiber tracts and in hippocampal and entorhinal cortex gray matter, respectively. Analyses evaluated whether these measures predicted memory performance, correlated with amyloid-β levels, and distinguished impaired individuals from controls. For comparison, analyses were repeated with standard diffusion tensor imaging (DTI) metrics of fractional anisotropy (FA) and mean diffusivity. Results Both RSI and DTI measures correlated with episodic memory and disease severity. RSI, but not DTI, measures correlated with amyloid-β42 levels. ND and FA in the arcuate fasciculus and entorhinal cortex IF most strongly predicted recall performance. RSI measures of arcuate fasciculus ND and entorhinal cortex IF best discriminated memory impaired participants from healthy participants. Conclusions RSI is highly sensitive to microstructural changes in the early stages of AD, and is associated with biochemical markers of AD pathology. Reduced ND in cortical association fibers and increased medial temporal lobe free-water diffusion predicted episodic memory, distinguished cognitively impaired from healthy individuals, and correlated with amyloid-β. Although further research is needed to assess the sensitivity of RSI to preclinical AD and disease progression, these results suggest that RSI may be a promising tool to better understand neuroanatomical changes in AD and their association with neuropathology. Electronic supplementary material The online version of this article (doi:10.1186/s13195-017-0281-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Emilie T Reas
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA. .,Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA.
| | - Donald J Hagler
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA.,Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA
| | - Nathan S White
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA.,Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA
| | - Joshua M Kuperman
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA.,Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA
| | - Hauke Bartsch
- Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA
| | - Karalani Cross
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Richard Q Loi
- Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA.,Wayne State University School of Medicine, Detroit, MI, USA
| | - Akshara R Balachandra
- Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA
| | - M J Meloy
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Christina E Wierenga
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.,Department of Veterans Affairs, San Diego Healthcare system, La Jolla, CA, USA
| | - Douglas Galasko
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - James B Brewer
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA.,Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Anders M Dale
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA.,Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA.,Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Linda K McEvoy
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA.,Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA.,Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
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