The Cortical Asymmetry Index for subtyping dementia patients

作者：Agnès Pérez‐Millan, Uma Maria Lal-Trehan Estrada, Neus Falgàs, Núria Guillén, Sergi Borrego‐Écija, Jordi Juncà‐Parella, Beatríz Bosch, Adrià Tort‐Merino, Jordi Sarto, Josep M. Augé, Anna Antonell, Núria Bargalló, Raquel Ruiz‐García, Laura Naranjo, Mircea Balasa, Albert Lladó, Roser Sala‐Llonch, Raquel Sánchez‐Valle · 发表于：European Radiology · 年份：2025 · DOI：10.1007/s00330-025-11400-y · 被引用次数：3 · 研究领域：Dementia and Cognitive Impairment Research、Functional Brain Connectivity Studies、Spatial Neglect and Hemispheric Dysfunction

OBJECTIVES: Frontotemporal dementia (FTD) usually shows more asymmetric atrophy patterns than Alzheimer's disease (AD). We aim to quantify this asymmetry to differentiate FTD, AD, and FTD subtypes. METHODS: We studied T1-MRI scans, including FTD (different phenotypes), AD, and healthy controls (CTR). We defined the Cortical Asymmetry Index (CAI) using measures based on a metric derived from information theory with the cortical thickness measures. Some participants had additional follow-up MRIs, cerebrospinal fluid (CSF), or plasma measures. We analysed differences at cross-sectional and longitudinal levels. We then clustered FTD and AD participants based on the CAI values and studied the patients' fluid biomarker characteristics within each cluster. RESULTS: A total of 101 FTD patients (64 ± 8 years, 53 men), 230 AD patients (65 ± 10 years, 84 men), and 173 CTR (59 ± 15 years, 67 men) were studied. CAI differentiated FTD, AD, and CTR. It also distinguished the semantic variant primary progressive aphasia (svPPA) from the other FTD phenotypes. In FTD, the CAI increased over time. The cluster analysis identified two subgroups within FTD, characterised by different neurofilament-light (NfL) levels, and two subgroups within AD, with different plasma glial fibrillary acidic protein (GFAP) levels. In AD, CAI correlated with GFAP and Mini-Mental State Examination (MMSE); in FTD, the CAI was associated with NfL levels. CONCLUSIONS: The proposed method quantifies asymmetries previousl...