4.5 Article

Quantitative Gradient Echo MRI Identifies Dark Matter as a New Imaging Biomarker of Neurodegeneration that Precedes Tissue Atrophy in Early Alzheimer's Disease

期刊

JOURNAL OF ALZHEIMERS DISEASE
卷 85, 期 2, 页码 905-924

出版社

IOS PRESS
DOI: 10.3233/JAD-210503

关键词

Alzheimer's disease; brain atrophy; cognitive impairment; hippocampal subfields; hippocampus; magnetic resonance imaging; neurodegeneration; quantitative Gradient Recalled Echo

资金

  1. NIH [R01 AG054513, P50 AG0581, P01 AG03991, P01 AG026276]

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This study utilizes qGRE MRI technique to evaluate neuronal loss in the human hippocampus. The results show that neuronal loss exceeds tissue atrophy in mild AD patients, providing new biomarkers for early AD diagnosis.
Background: Currently, brain tissue atrophy serves as an in vivo MRI biomarker of neurodegeneration in Alzheimer's disease (AD). However, postmortem histopathological studies show that neuronal loss in AD exceeds volumetric loss of tissue and that loss of memory in AD begins when neurons and synapses are lost. Therefore, in vivo detection of neuronal loss prior to detectable atrophy in MRI is essential for early AD diagnosis. Objective: To apply a recently developed quantitative Gradient Recalled Echo (qGRE) MRI technique for in vivo evaluation of neuronal loss in human hippocampus. Methods: Seventy participants were recruited from the Knight Alzheimer Disease Research Center, representing three groups: Healthy controls [Clinical Dementia Rating (R) (CDR (R)) = 0, amyloid beta (A beta)-negative, n = 34]; Preclinical AD (CDR = 0, A beta-positive, n = 19); and mild AD (CDR = 0.5 or 1, A beta-positive, n = 17). Results: In hippocampal tissue, qGRE identified two types of regions: one, practically devoid of neurons, we designate as Dark Matter, and the other, with relatively preserved neurons, Viable Tissue. Data showed a greater loss of neurons than defined by atrophy in the mild AD group compared with the healthy control group; neuronal loss ranged between 31% and 43%, while volume loss ranged only between 10% and 19%. The concept of Dark Matter was confirmed with histopathological study of one participant who underwent in vivo qGRE 14 months prior to expiration. Conclusion: In vivo qGRE method identifies neuronal loss that is associated with impaired AD-related cognition but is not recognized by MRI measurements of tissue atrophy, therefore providing new biomarkers for early AD detection.

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