Relating one-year cognitive change in mild cognitive impairment to baseline MRI features

Neuroimage. 2009 Oct 1;47(4):1363-70. doi: 10.1016/j.neuroimage.2009.04.023. Epub 2009 Apr 14.


Background: We propose a completely automated methodology to investigate the relationship between magnetic resonance image (MRI) features and changes in cognitive estimates, applied to the study of Mini-Mental State Examination (MMSE) changes in mild cognitive impairment (MCI).

Subjects: A reference group composed of 75 patients with clinically probable Alzheimer's Disease (AD) and 75 age-matched controls; and a study group composed of 49 MCI, 20 having progressed to clinically probable AD and 29 having remained stable after a 48 month follow-up.

Methods: We created a pathology-specific reference space using principal component analysis of MRI-based features (intensity, local volume changes) within the medial temporal lobe of T1-weighted baseline images for the reference group. We projected similar data from the study group and identified a restricted set of image features highly correlated with one-year change in MMSE, using a bootstrap sampling estimation. We used robust linear regression models to predict one-year MMSE changes from baseline MRI, baseline MMSE, age, gender, and years of education.

Results: All experiments were performed using a leave-one-out paradigm. We found multiple image-based features highly correlated with one-year MMSE changes (/r/>0.425). The model for all N=49 MCI subjects had a correlation of r=0.31 between actual and predicted one-year MMSE change values. A second model only for MCI subjects with MMSE loss larger than 1 U had a pairwise correlation r=0.80 with an adjusted coefficient of determination r(2)=0.61.

Findings: Our automated MRI-based technique revealed a strong relationship between baseline MRI features and one-year cognitive changes in a sub-group of MCI subjects. This technique should be generalized to other aspects of cognitive evaluation and to a wider scope of dementias.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Algorithms*
  • Alzheimer Disease / complications
  • Alzheimer Disease / pathology*
  • Brain / pathology*
  • Cognition Disorders / complications
  • Cognition Disorders / pathology*
  • Female
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods*
  • Magnetic Resonance Imaging / methods*
  • Magnetic Resonance Imaging / standards
  • Male
  • Reference Values
  • Reproducibility of Results
  • Sensitivity and Specificity