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Feis RA, Bouts MJRJ, de Vos F, Schouten TM, Panman JL, Jiskoot LC, Dopper EGP, van der Grond J, van Swieten JC, Rombouts SARB. A multimodal MRI-based classification signature emerges just prior to symptom onset in frontotemporal dementia mutation carriers. J Neurol Neurosurg Psychiatry 2019; 90:1207-1214. [PMID: 31203211 DOI: 10.1136/jnnp-2019-320774] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/26/2019] [Accepted: 05/12/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Multimodal MRI-based classification may aid early frontotemporal dementia (FTD) diagnosis. Recently, presymptomatic FTD mutation carriers, who have a high risk of developing FTD, were separated beyond chance level from controls using MRI-based classification. However, it is currently unknown how these scores from classification models progress as mutation carriers approach symptom onset. In this longitudinal study, we investigated multimodal MRI-based classification scores between presymptomatic FTD mutation carriers and controls. Furthermore, we contrasted carriers that converted during follow-up ('converters') and non-converting carriers ('non-converters'). METHODS We acquired anatomical MRI, diffusion tensor imaging and resting-state functional MRI in 55 presymptomatic FTD mutation carriers and 48 healthy controls at baseline, and at 2, 4, and 6 years of follow-up as available. At each time point, FTD classification scores were calculated using a behavioural variant FTD classification model. Classification scores were tested in a mixed-effects model for mean differences and differences over time. RESULTS Presymptomatic mutation carriers did not have higher classification score increase over time than controls (p=0.15), although carriers had higher FTD classification scores than controls on average (p=0.032). However, converters (n=6) showed a stronger classification score increase over time than non-converters (p<0.001). CONCLUSIONS Our findings imply that presymptomatic FTD mutation carriers may remain similar to controls in terms of MRI-based classification scores until they are close to symptom onset. This proof-of-concept study shows the promise of longitudinal MRI data acquisition in combination with machine learning to contribute to early FTD diagnosis.
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Affiliation(s)
- Rogier A Feis
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands .,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.,Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Mark J R J Bouts
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.,Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Frank de Vos
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.,Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Tijn M Schouten
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.,Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Jessica L Panman
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Lize C Jiskoot
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Elise G P Dopper
- Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - John C van Swieten
- Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Clinical Genetics, VU University Medical Centre, Amsterdam, The Netherlands
| | - Serge A R B Rombouts
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.,Institute of Psychology, Leiden University, Leiden, The Netherlands
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