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ApoE4 effects on automated diagnostic classifiers for mild cognitive impairment and Alzheimer's disease

Identifieur interne : 003E34 ( Main/Exploration ); précédent : 003E33; suivant : 003E35

ApoE4 effects on automated diagnostic classifiers for mild cognitive impairment and Alzheimer's disease

Auteurs : Liana G. Apostolova [États-Unis] ; Kristy S. Hwang [États-Unis] ; Omid Kohannim [États-Unis] ; David Avila [États-Unis] ; David Elashoff [États-Unis] ; Clifford R. Jack [États-Unis] ; Leslie Shaw [États-Unis] ; John Q. Trojanowski [États-Unis] ; Michael W. Weiner [États-Unis] ; Paul M. Thompson [États-Unis]

Source :

RBID : PMC:3952354

Descripteurs français

English descriptors

Abstract

Biomarkers are the only feasible way to detect and monitor presymptomatic Alzheimer's disease (AD). No single biomarker can predict future cognitive decline with an acceptable level of accuracy. In addition to designing powerful multimodal diagnostic platforms, a careful investigation of the major sources of disease heterogeneity and their influence on biomarker changes is needed. Here we investigated the accuracy of a novel multimodal biomarker classifier for differentiating cognitively normal (NC), mild cognitive impairment (MCI) and AD subjects with and without stratification by ApoE4 genotype. 111 NC, 182 MCI and 95 AD ADNI participants provided both structural MRI and CSF data at baseline. We used an automated machine-learning classifier to test the ability of hippocampal volume and CSF Aβ, t-tau and p-tau levels, both separately and in combination, to differentiate NC, MCI and AD subjects, and predict conversion. We hypothesized that the combined hippocampal/CSF biomarker classifier model would achieve the highest accuracy in differentiating between the three diagnostic groups and that ApoE4 genotype will affect both diagnostic accuracy and biomarker selection. The combined hippocampal/CSF classifier performed better than hippocampus-only classifier in differentiating NC from MCI and NC from AD. It also outperformed the CSF-only classifier in differentiating NC vs. AD. Our amyloid marker played a role in discriminating NC from MCI or AD but not for MCI vs. AD. Neurodegenerative markers contributed to accurate discrimination of AD from NC and MCI but not NC from MCI. Classifiers predicting MCI conversion performed well only after ApoE4 stratification. Hippocampal volume and sex achieved AUC = 0.68 for predicting conversion in the ApoE4-positive MCI, while CSF p-tau, education and sex achieved AUC = 0.89 for predicting conversion in ApoE4-negative MCI. These observations support the proposed biomarker trajectory in AD, which postulates that amyloid markers become abnormal early in the disease course while markers of neurodegeneration become abnormal later in the disease course and suggests that ApoE4 could be at least partially responsible for some of the observed disease heterogeneity.


Url:
DOI: 10.1016/j.nicl.2013.12.012
PubMed: 24634832
PubMed Central: 3952354


Affiliations:


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Le document en format XML

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<term>Aged, 80 and over</term>
<term>Algorithms</term>
<term>Alzheimer Disease (cerebrospinal fluid)</term>
<term>Alzheimer Disease (diagnosis)</term>
<term>Apolipoprotein E4 (cerebrospinal fluid)</term>
<term>Atrophy (pathology)</term>
<term>Biomarkers (cerebrospinal fluid)</term>
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<term>Hippocampus (pathology)</term>
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<term>Machine Learning</term>
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<term>Middle Aged</term>
<term>Nerve Tissue Proteins (cerebrospinal fluid)</term>
<term>Organ Size</term>
<term>Reproducibility of Results</term>
<term>Sensitivity and Specificity</term>
<term>Tissue Distribution</term>
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<term>Adulte d'âge moyen</term>
<term>Algorithmes</term>
<term>Apolipoprotéine E4 ()</term>
<term>Apprentissage machine</term>
<term>Atrophie (anatomopathologie)</term>
<term>Diagnostic assisté par ordinateur ()</term>
<term>Diagnostic différentiel</term>
<term>Dysfonctionnement cognitif ()</term>
<term>Dysfonctionnement cognitif (diagnostic)</term>
<term>Femelle</term>
<term>Hippocampe (anatomopathologie)</term>
<term>Hippocampe (métabolisme)</term>
<term>Humains</term>
<term>Maladie d'Alzheimer ()</term>
<term>Maladie d'Alzheimer (diagnostic)</term>
<term>Marqueurs biologiques ()</term>
<term>Mâle</term>
<term>Protéines de tissu nerveux ()</term>
<term>Reproductibilité des résultats</term>
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<term>Sujet âgé de 80 ans ou plus</term>
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<term>Apolipoprotein E4</term>
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<term>Atrophie</term>
<term>Hippocampe</term>
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<term>Alzheimer Disease</term>
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<term>Cognitive Dysfunction</term>
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<term>Dysfonctionnement cognitif</term>
<term>Maladie d'Alzheimer</term>
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<term>Hippocampus</term>
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<term>Diagnosis, Computer-Assisted</term>
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<term>Atrophy</term>
<term>Hippocampus</term>
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<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Algorithms</term>
<term>Diagnosis, Differential</term>
<term>Female</term>
<term>Humans</term>
<term>Machine Learning</term>
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<term>Middle Aged</term>
<term>Organ Size</term>
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<term>Tissue Distribution</term>
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<term>Adulte d'âge moyen</term>
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<term>Apolipoprotéine E4</term>
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<term>Diagnostic assisté par ordinateur</term>
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<term>Maladie d'Alzheimer</term>
<term>Marqueurs biologiques</term>
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<term>Répartition dans les tissus</term>
<term>Sensibilité et spécificité</term>
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<term>Sujet âgé de 80 ans ou plus</term>
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<div type="abstract" xml:lang="en">
<p>Biomarkers are the only feasible way to detect and monitor presymptomatic Alzheimer's disease (AD). No single biomarker can predict future cognitive decline with an acceptable level of accuracy. In addition to designing powerful multimodal diagnostic platforms, a careful investigation of the major sources of disease heterogeneity and their influence on biomarker changes is needed. Here we investigated the accuracy of a novel multimodal biomarker classifier for differentiating cognitively normal (NC), mild cognitive impairment (MCI) and AD subjects with and without stratification by ApoE4 genotype. 111 NC, 182 MCI and 95 AD ADNI participants provided both structural MRI and CSF data at baseline. We used an automated machine-learning classifier to test the ability of hippocampal volume and CSF Aβ, t-tau and p-tau levels, both separately and in combination, to differentiate NC, MCI and AD subjects, and predict conversion. We hypothesized that the combined hippocampal/CSF biomarker classifier model would achieve the highest accuracy in differentiating between the three diagnostic groups and that ApoE4 genotype will affect both diagnostic accuracy and biomarker selection. The combined hippocampal/CSF classifier performed better than hippocampus-only classifier in differentiating NC from MCI and NC from AD. It also outperformed the CSF-only classifier in differentiating NC vs. AD. Our amyloid marker played a role in discriminating NC from MCI or AD but not for MCI vs. AD. Neurodegenerative markers contributed to accurate discrimination of AD from NC and MCI but not NC from MCI. Classifiers predicting MCI conversion performed well only after ApoE4 stratification. Hippocampal volume and sex achieved AUC = 0.68 for predicting conversion in the ApoE4-positive MCI, while CSF p-tau, education and sex achieved AUC = 0.89 for predicting conversion in ApoE4-negative MCI. These observations support the proposed biomarker trajectory in AD, which postulates that amyloid markers become abnormal early in the disease course while markers of neurodegeneration become abnormal later in the disease course and suggests that ApoE4 could be at least partially responsible for some of the observed disease heterogeneity.</p>
</div>
</front>
<back>
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</back>
</TEI>
<affiliations>
<list>
<country>
<li>États-Unis</li>
</country>
<region>
<li>Californie</li>
<li>Minnesota</li>
<li>Pennsylvanie</li>
</region>
<settlement>
<li>Los Angeles</li>
<li>Pittsburgh</li>
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<orgName>
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<li>Université de Pittsburgh</li>
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<country name="États-Unis">
<region name="Californie">
<name sortKey="Apostolova, Liana G" sort="Apostolova, Liana G" uniqKey="Apostolova L" first="Liana G." last="Apostolova">Liana G. Apostolova</name>
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</tree>
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