1
|
Chen B, Xu M, Yu H, He J, Li Y, Song D, Fan GG. Detection of mild cognitive impairment in Parkinson's disease using gradient boosting decision tree models based on multilevel DTI indices. J Transl Med 2023; 21:310. [PMID: 37158918 PMCID: PMC10165759 DOI: 10.1186/s12967-023-04158-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/25/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Cognitive dysfunction is the most common non-motor symptom in Parkinson's disease (PD), and timely detection of a slight cognitive decline is crucial for early treatment and prevention of dementia. This study aimed to build a machine learning model based on intra- and/or intervoxel metrics extracted from diffusion tensor imaging (DTI) to automatically classify PD patients without dementia into mild cognitive impairment (PD-MCI) and normal cognition (PD-NC) groups. METHODS We enrolled PD patients without dementia (52 PD-NC and 68 PD-MCI subtypes) who were assigned to the training and test datasets in an 8:2 ratio. Four intravoxel metrics, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD), and two novel intervoxel metrics, local diffusion homogeneity (LDH) using Spearman's rank correlation coefficient (LDHs) and Kendall's coefficient concordance (LDHk), were extracted from the DTI data. Decision tree, random forest, and eXtreme gradient boosting (XGBoost) models based on individual and combined indices were built for classification, and model performance was assessed and compared via the area under the receiver operating characteristic curve (AUC). Finally, feature importance was evaluated using SHapley Additive exPlanation (SHAP) values. RESULTS The XGBoost model based on a combination of the intra- and intervoxel indices achieved the best classification performance, with an accuracy of 91.67%, sensitivity of 92.86%, and AUC of 0.94 in the test dataset. SHAP analysis showed that the LDH of the brainstem and MD of the right cingulum (hippocampus) were important features. CONCLUSIONS More comprehensive information on white matter changes can be obtained by combining intra- and intervoxel DTI indices, improving classification accuracy. Furthermore, machine learning methods based on DTI indices can be used as alternatives for the automatic identification of PD-MCI at the individual level.
Collapse
Affiliation(s)
- Boyu Chen
- Department of Radiology, The First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang, 110001, Liaoning, China
| | - Ming Xu
- Shenyang University of Technology, No.111, Shenliao West Road, Shenyang, 110870, Liaoning, China
| | - Hongmei Yu
- Department of Neurology, The First Hospital of China Medical University, No. 155, Nanjing North Street, Shenyang, 110001, Liaoning, China
| | - Jiachuan He
- Department of Radiology, The First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang, 110001, Liaoning, China
| | - Yingmei Li
- Department of Radiology, The First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang, 110001, Liaoning, China
| | - Dandan Song
- Department of Radiology, The First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang, 110001, Liaoning, China
| | - Guo Guang Fan
- Department of Radiology, The First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang, 110001, Liaoning, China.
| |
Collapse
|
2
|
Bandopadhyay R, Singh T, Ghoneim MM, Alshehri S, Angelopoulou E, Paudel YN, Piperi C, Ahmad J, Alhakamy NA, Alfaleh MA, Mishra A. Recent Developments in Diagnosis of Epilepsy: Scope of MicroRNA and Technological Advancements. BIOLOGY 2021; 10:1097. [PMID: 34827090 PMCID: PMC8615191 DOI: 10.3390/biology10111097] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 12/18/2022]
Abstract
Epilepsy is one of the most common neurological disorders, characterized by recurrent seizures, resulting from abnormally synchronized episodic neuronal discharges. Around 70 million people worldwide are suffering from epilepsy. The available antiepileptic medications are capable of controlling seizures in around 60-70% of patients, while the rest remain refractory. Poor seizure control is often associated with neuro-psychiatric comorbidities, mainly including memory impairment, depression, psychosis, neurodegeneration, motor impairment, neuroendocrine dysfunction, etc., resulting in poor prognosis. Effective treatment relies on early and correct detection of epileptic foci. Although there are currently a few well-established diagnostic techniques for epilepsy, they lack accuracy and cannot be applied to patients who are unsupportive or harbor metallic implants. Since a single test result from one of these techniques does not provide complete information about the epileptic foci, it is necessary to develop novel diagnostic tools. Herein, we provide a comprehensive overview of the current diagnostic tools of epilepsy, including electroencephalography (EEG) as well as structural and functional neuroimaging. We further discuss recent trends and advances in the diagnosis of epilepsy that will enable more effective diagnosis and clinical management of patients.
Collapse
Affiliation(s)
- Ritam Bandopadhyay
- Department of Pharmacology, School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, Punjab, India;
| | - Tanveer Singh
- Department of Neuroscience and Experimental Therapeutics, College of Medicine, Texas A&M University Health Science Center, Bryan, TX 77807, USA;
| | - Mohammed M. Ghoneim
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Ad Diriyah 13713, Saudi Arabia;
| | - Sultan Alshehri
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Efthalia Angelopoulou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.A.); (C.P.)
| | - Yam Nath Paudel
- Neuropharmacology Research Strength, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Subang Jaya 47500, Selangor, Malaysia;
| | - Christina Piperi
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.A.); (C.P.)
| | - Javed Ahmad
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran 11001, Saudi Arabia;
| | - Nabil A. Alhakamy
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (N.A.A.); (M.A.A.)
| | - Mohamed A. Alfaleh
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (N.A.A.); (M.A.A.)
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Awanish Mishra
- Department of Pharmacology, School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, Punjab, India;
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER)—Guwahati, Changsari, Guwahati 781101, Assam, India
| |
Collapse
|
3
|
Zhang Y, Huang B, Chen Q, Wang L, Zhang L, Nie K, Huang Q, Huang R. Altered microstructural properties of superficial white matter in patients with Parkinson's disease. Brain Imaging Behav 2021; 16:476-491. [PMID: 34410610 DOI: 10.1007/s11682-021-00522-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 12/31/2022]
Abstract
Parkinson's disease (PD), a chronic neurodegenerative disease, is characterized by sensorimotor and cognitive deficits. Previous diffusion tensor imaging (DTI) studies found abnormal DTI metrics in white matter bundles, such as the corpus callosum, cingulate, and frontal-parietal bundles, in PD patients. These studies mainly focused on alterations in microstructural features of long-range bundles within the deep white matter (DWM) that connects pairs of distant cortical regions. However, less is known about the DTI metrics of the superficial white matter (SWM) that connects local cortical regions in PD patients. To determine whether the DTI metrics of the SWM were different between the PD patients and the healthy controls, we recruited DTI data from 34 PD patients and 29 gender- and age-matched healthy controls. Using a probabilistic tractographic approach, we first defined a population-based SWM mask across all the subjects. Using a tract-based spatial statistical (TBSS) analytic approach, we then identified the SWM bundles showing abnormal DTI metrics in the PD patients. We found that the PD patients showed significantly lower DTI metrics in the SWM bundles connecting the sensorimotor cortex, cingulate cortex, posterior parietal cortex (PPC), and parieto-occipital cortex than the healthy controls. We also found that the clinical measures in the PD patients was significantly negatively correlated with the fractional anisotropy in the SWM (FASWM) that connects core regions in the default mode network (DMN). The FASWM in the bundles that connected the PPC was significantly positively correlated with cognitive performance in the PD patients. Our findings suggest that SWM may serve as the brain structural basis underlying the sensorimotor deficits and cognitive degeneration in PD patients.
Collapse
Affiliation(s)
- Yichen Zhang
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China
| | - Biao Huang
- Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, 510080 , China.
| | - Qinyuan Chen
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China
| | - Lijuan Wang
- Department of Neurology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, 510080, China
| | - Lu Zhang
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China
| | - Kun Nie
- Department of Neurology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, 510080, China
| | - Qinda Huang
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China
| | - Ruiwang Huang
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China.
| |
Collapse
|
4
|
Liu G, Gao Y, Liu Y, Guo Y, Yan Z, Ou Z, Zhong L, Xie C, Zeng J, Zhang W, Peng K, Lv Q. Machine Learning for Predicting Individual Severity of Blepharospasm Using Diffusion Tensor Imaging. Front Neurosci 2021; 15:670475. [PMID: 34054417 PMCID: PMC8155629 DOI: 10.3389/fnins.2021.670475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 04/12/2021] [Indexed: 11/17/2022] Open
Abstract
Accumulating diffusion tensor imaging (DTI) evidence suggests that white matter abnormalities evaluated by local diffusion homogeneity (LDH) or fractional anisotropy (FA) occur in patients with blepharospasm (BSP), both of which are significantly correlated with disease severity. However, whether the individual severity of BSP can be identified using these DTI metrics remains unknown. We aimed to investigate whether a combination of machine learning techniques and LDH or FA can accurately identify the individual severity of BSP. Forty-one patients with BSP were assessed using the Jankovic Rating Scale and DTI. The patients were assigned to non-functionally and functionally limited groups according to their Jankovic Rating Scale scores. A machine learning scheme consisting of beam search and support vector machines was designed to identify non-functionally versus functionally limited outcomes, with the input features being LDH or FA in 68 white matter regions. The proposed machine learning scheme with LDH or FA yielded an overall accuracy of 88.67 versus 85.19% in identifying non-functionally limited versus functionally limited outcomes. The scheme also identified a sensitivity of 91.40 versus 85.87% in correctly identifying functionally limited outcomes, a specificity of 83.33 versus 83.67% in accurately identifying non-functionally limited outcomes, and an area under the curve of 93.7 versus 91.3%. These findings suggest that a combination of LDH or FA measurements and a sophisticated machine learning scheme can accurately and reliably identify the individual disease severity in patients with BSP.
Collapse
Affiliation(s)
- Gang Liu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Yanan Gao
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China.,Department of Information, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ying Liu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Yaomin Guo
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Zhicong Yan
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Zilin Ou
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Linchang Zhong
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Chuanmiao Xie
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Jinsheng Zeng
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Weixi Zhang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Kangqiang Peng
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Qingwen Lv
- Department of Information, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| |
Collapse
|
5
|
Dmour HH, Khreisat EF, Khreisat AF, Hasan SA, Atoom O, Alkhatib AJ. Assessment of Lactate Dehydrogenase Levels Among Diabetic Patients Treated in the Outpatient Clinics at King Hussein Medical Center, Royal Medical Services, Jordan. Med Arch 2021; 74:384-386. [PMID: 33424095 PMCID: PMC7780787 DOI: 10.5455/medarh.2020.74.384-386] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Introduction Diabetes is a chronic disease and usually is associated with inflammatory conditions. Although assessment of inflammatory markers such lactate dehydrogenase (LDH) is not likely to be conducted in routine practice, it can help in monitoring disease progress. Aim The main objectives of the present study are to assess the levels of LDH among diabetic patients treated in the outpatient clinics at King Hussein Medical Center, and to investigate the relationships between the levels of LDH and other variables such as age, gender, BMI, and glucose levels. Methods A retrospective study was conducted to collect data from files of diabetic patients. A total of 62 files were selected. Files of diabetic patients were included if complete information including LDH are included. An excel sheet was used to enter the raw data for all patients. The data were analyzed using SPSS version 20. Data were presented as means, standard deviations, frequencies and percentages. The relationships between variables were computed using T test, and Chi-square. The significance will be considered at p ≤ 0.05. Results The mean age was 75±12 years. About 53% of participants were males. The mean of BMI was 31.47±20.90 kg/m2. The mean glucose level was 239±85 mg/dl. The mean level of LDH was 328.34±78 U/L. There was a significant association between the level of LDH and study variables. Gender had no significant impacts on the levels of LH and other study variables. Conclusion Determination of the level of LDH helps in assessment of progression of diabetes and it is recommended to be performed clinically in routine practice.
Collapse
Affiliation(s)
| | | | | | | | | | - Ahed J Alkhatib
- Department of Legal Medicine, Toxicology and Forensic Medicine, Jordan University of Science and Technology, Aman, Jordan
| |
Collapse
|
6
|
Guo Y, Peng K, Ou Z, Zhong L, Wang Y, Xie C, Zeng J, Zhang W, Liu G. Structural Brain Changes in Blepharospasm: A Cortical Thickness and Diffusion Tensor Imaging Study. Front Neurosci 2020; 14:543802. [PMID: 33192242 PMCID: PMC7658539 DOI: 10.3389/fnins.2020.543802] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 10/09/2020] [Indexed: 12/29/2022] Open
Abstract
White matter abnormalities in blepharospasm (BSP) have been evaluated using conventional intra-voxel metrics, and changes in patterns of cortical thickness in BSP remain controversial. We aimed to determine whether local diffusion homogeneity, an inter-voxel diffusivity metric, could be valuable in detecting white matter abnormalities for BSP; whether these changes are related to disease features; and whether cortical thickness changes occur in BSP patients. Diffusion tensor and structural magnetic resonance imaging were collected for 29 patients with BSP and 30 healthy controls. Intergroup diffusion differences were compared using tract-based spatial statistics analysis and measures of cortical thickness were obtained. The relationship among cortical thickness, diffusion metric in significantly different regions, and behavioral measures were further assessed. There were no significant differences in cortical thickness and fractional anisotropy between the groups. Local diffusion homogeneity was higher in BSP patients than controls, primarily in the left superior longitudinal fasciculus, corpus callosum, left posterior corona radiata, and left posterior thalamic radiata (P < 0.05, family-wise error corrected). The local diffusion homogeneity values in these regions were positively correlated with the Jankovic rating scale (rs = 0.416, P = 0.031) and BSP disability index (rs = 0.453, P = 0.018) in BSP patients. These results suggest that intra- and inter-voxel diffusive parameters are differentially sensitive to detecting BSP-related white matter abnormalities and that local diffusion homogeneity might be useful in assessing disability in BSP patients.
Collapse
Affiliation(s)
- Yaomin Guo
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Kangqiang Peng
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Zilin Ou
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Linchang Zhong
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ying Wang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Chuanmiao Xie
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Jinsheng Zeng
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Weixi Zhang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Gang Liu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| |
Collapse
|
7
|
Du XQ, Zou TX, Huang NX, Zou ZY, Xue YJ, Chen HJ. Brain white matter abnormalities and correlation with severity in amyotrophic lateral sclerosis: An atlas-based diffusion tensor imaging study. J Neurol Sci 2019; 405:116438. [PMID: 31484082 DOI: 10.1016/j.jns.2019.116438] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 08/23/2019] [Accepted: 08/28/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess microstructural alterations in white matter (WM) in amyotrophic lateral sclerosis (ALS) using diffusion tensor imaging (DTI). METHODS DTI data were collected from 34 subjects (18 patients with ALS and 16 healthy controls). The atlas-based region of interest (ROI) analysis was conducted to assess WM microstructure in ALS by combining intra-voxel metrics, which included fractional anisotropy (FA) and mean diffusivity (MD), and an inter-voxel metric, i.e., local diffusion homogeneity (LDH). Correlation analysis of diffusion values and clinical factors was also performed. RESULTS ALS group showed a significant FA reduction in bilateral corticospinal tract (CST) as well as right uncinate fasciculus (RUF). The areas with higher MD were situated in right corticospinal tract (RCST), left cingulum hippocampus (LCH), RUF, and right superior longitudinal fasciculus (RSLF). Additionally, ALS patients showed decreased LDH in bilateral anterior thalamic radiation (ATR), bilateral CST and left inferior frontal-occipital fasciculus (LIFOF). Significant correlations were observed between ALSFRS-R (revised ALS Functional Rating Scale) scores or progression rate and FA in bilateral CST, as well as between disease duration and LDH in right CST. Receiver operating characteristic (ROC) analysis revealed the feasibility of employing diffusion metrics along the CST to distinguish two groups (AUC = 0.792-0.868, p < .005 for all). CONCLUSIONS WM microstructural alteration is a common pathology in ALS, which can be detected by both intra- and inter-voxel diffusion metrics. The extent of abnormalities in several WM tracts such as ATR and LIFOF may be better assessed through the inter-voxel diffusion measurement.
Collapse
Affiliation(s)
- Xiao-Qiang Du
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Tian-Xiu Zou
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Nao-Xin Huang
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Zhang-Yu Zou
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou 350001, China.
| | - Yun-Jing Xue
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou 350001, China.
| | - Hua-Jun Chen
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou 350001, China.
| |
Collapse
|
8
|
Liang Y, Zhang H, Tan X, Liu J, Qin C, Zeng H, Zheng Y, Liu Y, Chen J, Leng X, Qiu S, Shen D. Local Diffusion Homogeneity Provides Supplementary Information in T2DM-Related WM Microstructural Abnormality Detection. Front Neurosci 2019; 13:63. [PMID: 30792623 PMCID: PMC6374310 DOI: 10.3389/fnins.2019.00063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/22/2019] [Indexed: 12/30/2022] Open
Abstract
Objectives: We aimed to investigate whether an inter-voxel diffusivity metric (local diffusion homogeneity, LDH), can provide supplementary information to traditional intra-voxel metrics (i.e., fractional anisotropy, FA) in white matter (WM) abnormality detection for type 2 diabetes mellitus (T2DM). Methods: Diffusion tensor imaging was acquired from 34 T2DM patients and 32 healthy controls. Voxel-based group-difference comparisons based on LDH and FA, as well as the association between the diffusion metrics and T2DM risk factors [i.e., body mass index (BMI) and systolic blood pressure (SBP)], were conducted, with age, gender and education level controlled. Results: Compared to the controls, T2DM patients had higher LDH in the pons and left temporal pole, as well as lower FA in the left superior corona radiation (p < 0.05, corrected). In T2DM, there were several overlapping WM areas associated with BMI as revealed by both LDH and FA, including right temporal lobe and left inferior parietal lobe; but the unique areas revealed only by using LDH included left inferior temporal lobe, right supramarginal gyrus, left pre- and post-central gyrus (at the semiovale center), and right superior radiation. Overlapping WM areas that associated with SBP were found with both LDH and FA, including right temporal pole, bilateral orbitofrontal area (rectus gyrus), the media cingulum bundle, and the right cerebellum crus I. However, the unique areas revealed only by LDH included right inferior temporal lobe, right inferior occipital lobe, and splenium of corpus callosum. Conclusion: Inter- and intra-voxel diffusivity metrics may have different sensitivity in the detection of T2DM-related WM abnormality. We suggested that LDH could provide supplementary information and reveal additional underlying brain changes due to diabetes.
Collapse
Affiliation(s)
- Yi Liang
- Medical Imaging Research Office, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Medical Imaging, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Han Zhang
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Xin Tan
- Department of Medical Imaging, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiarui Liu
- Medical Imaging Research Office, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunhong Qin
- Department of Medical Imaging, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hui Zeng
- Medical Imaging Research Office, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yanting Zheng
- Medical Imaging Research Office, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yujie Liu
- Medical Imaging Research Office, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jingxian Chen
- Medical Imaging Research Office, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xi Leng
- Department of Medical Imaging, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shijun Qiu
- Medical Imaging Research Office, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Medical Imaging, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dinggang Shen
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Department of Brain and Cognitive Engineering, Korea University, Seoul, South Korea
| |
Collapse
|
9
|
Pitkänen A, Ekolle Ndode-Ekane X, Lapinlampi N, Puhakka N. Epilepsy biomarkers - Toward etiology and pathology specificity. Neurobiol Dis 2018; 123:42-58. [PMID: 29782966 DOI: 10.1016/j.nbd.2018.05.007] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 05/13/2018] [Accepted: 05/16/2018] [Indexed: 02/07/2023] Open
Abstract
A biomarker is a characteristic that is measured as an indicator of normal biologic processes, pathogenic processes, or responses to an exposure or intervention, including therapeutic interventions. Biomarker modalities include molecular, histologic, radiographic, or physiologic characteristics. In 2015, the FDA-NIH Joint Leadership Council developed the BEST Resource (Biomarkers, EndpointS, and other Tools) to improve the understanding and use of biomarker terminology in biomedical research, clinical practice, and medical product development. The BEST biomarker categories include: (a) susceptibility/risk biomarkers, (b) diagnostic biomarkers, (c) monitoring biomarkers, (d) prognostic biomarkers, (e) predictive biomarkers, (f) pharmacodynamic/response biomarkers, and (g) safety biomarkers. Here we review 30 epilepsy biomarker studies that have identified (a) diagnostic biomarkers for epilepsy, epileptogenesis, epileptogenicity, drug-refractoriness, and status epilepticus - some of the epileptogenesis and epileptogenicity biomarkers can also be considered prognostic biomarkers for the development of epilepsy in subjects with a given brain insult, (b) predictive biomarkers for epilepsy surgery outcome, and (c) a response biomarker for therapy outcome. The biomarker modalities include plasma/serum/exosomal and cerebrospinal fluid molecular biomarkers, brain tissue molecular biomarkers, imaging biomarkers, electrophysiologic biomarkers, and behavioral/cognitive biomarkers. Both single and combinatory biomarkers have been described. Most of the reviewed biomarkers have an area under the curve >0.800 in receiver operating characteristics analysis, suggesting high sensitivity and specificity. As discussed in this review, we are in the early phase of the learning curve in epilepsy biomarker discovery. Many of the seven biomarker categories lack epilepsy-related biomarkers. There is a need for epilepsy biomarker discovery using proper, statistically powered study designs with validation cohorts, and the development and use of novel analytical methods. A strategic roadmap to discuss the research priorities in epilepsy biomarker discovery, regulatory issues, and optimization of the use of resources, similar to those devised in the cancer and Alzheimer's disease research areas, is also needed.
Collapse
Affiliation(s)
- Asla Pitkänen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, PO Box 1627, FIN-70211 Kuopio, Finland.
| | - Xavier Ekolle Ndode-Ekane
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, PO Box 1627, FIN-70211 Kuopio, Finland
| | - Niina Lapinlampi
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, PO Box 1627, FIN-70211 Kuopio, Finland
| | - Noora Puhakka
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, PO Box 1627, FIN-70211 Kuopio, Finland
| |
Collapse
|
10
|
Liu G, Tan S, Dang C, Peng K, Xie C, Xing S, Zeng J. Motor Recovery Prediction With Clinical Assessment and Local Diffusion Homogeneity After Acute Subcortical Infarction. Stroke 2017. [PMID: 28630233 DOI: 10.1161/strokeaha.117.017060] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Gang Liu
- From the Department of Neurology and Stroke Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (G.L., S.T., C.D., S.X., J.Z.); and State Key Laboratory of Oncology in Southern China, Imaging Diagnosis and Interventional Center, Cancer Center of Sun Yat-sen University, Guangzhou, China (K.P., C.X.)
| | - Shuangquan Tan
- From the Department of Neurology and Stroke Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (G.L., S.T., C.D., S.X., J.Z.); and State Key Laboratory of Oncology in Southern China, Imaging Diagnosis and Interventional Center, Cancer Center of Sun Yat-sen University, Guangzhou, China (K.P., C.X.)
| | - Chao Dang
- From the Department of Neurology and Stroke Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (G.L., S.T., C.D., S.X., J.Z.); and State Key Laboratory of Oncology in Southern China, Imaging Diagnosis and Interventional Center, Cancer Center of Sun Yat-sen University, Guangzhou, China (K.P., C.X.)
| | - Kangqiang Peng
- From the Department of Neurology and Stroke Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (G.L., S.T., C.D., S.X., J.Z.); and State Key Laboratory of Oncology in Southern China, Imaging Diagnosis and Interventional Center, Cancer Center of Sun Yat-sen University, Guangzhou, China (K.P., C.X.)
| | - Chuanmiao Xie
- From the Department of Neurology and Stroke Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (G.L., S.T., C.D., S.X., J.Z.); and State Key Laboratory of Oncology in Southern China, Imaging Diagnosis and Interventional Center, Cancer Center of Sun Yat-sen University, Guangzhou, China (K.P., C.X.)
| | - Shihui Xing
- From the Department of Neurology and Stroke Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (G.L., S.T., C.D., S.X., J.Z.); and State Key Laboratory of Oncology in Southern China, Imaging Diagnosis and Interventional Center, Cancer Center of Sun Yat-sen University, Guangzhou, China (K.P., C.X.)
| | - Jinsheng Zeng
- From the Department of Neurology and Stroke Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (G.L., S.T., C.D., S.X., J.Z.); and State Key Laboratory of Oncology in Southern China, Imaging Diagnosis and Interventional Center, Cancer Center of Sun Yat-sen University, Guangzhou, China (K.P., C.X.)
| |
Collapse
|