Combining imaging and assessment can predict Alzheimer's two years
18 December 2013
A combination of brain analysis by MRI with a neuropsychological
assessment can accurately predict whether people with mild cognitive impairment
get Alzheimer's disease within two years.
The findings, by Sylvie Belleville, PhD, Director of Research at the Institut universitaire de gériatrie de Montréal, and her team
have been published in the
Journal of Alzheimer's Disease .
The strongest neuroimaging predictors were baseline cortical
thickness in the right anterior cingulate and middle frontal gyri.
For cognitive predictors, deficits in both free recall
and recognition episodic memory tasks were highly suggestive of
progression to dementia. Cortical thinning in the right anterior cingulate gyrus, combined to controlled and familiarity-based
retrieval deficits, achieved a classification accuracy of 87.5%, a
specificity of 90.9% and a sensitivity of 83.3%. This predictive
model including both classes of measures provided more accurate
predictions than those based on neuroimaging or cognitive measures
“At the moment, we can't diagnose this disease very early due to the
lack of reliable protocols. Thus, there is a risk of erroneously
identifying the disease when trying to diagnose it too early.
Identifying markers that correctly predict the subsequent onset of more
severe symptoms that are sensitive and specific considerably reduces the
uncertainty of early diagnosis. The innovation here is showing that two
different approaches can be combined to aid in diagnosis,” said Sylvie
“When used individually, neuroimaging and neuropsychology are
effective but only up to a certain point. It is when combining and
analyzing the results from both methods that we could achieve such
an exceptional level of accuracy.
“The clinical benefits of these extra two years are enormous. We can
now evaluate the effectiveness of pharmacological and
non-pharmacological therapies on the outcome of a clinical diagnosis
of Alzheimer's disease in people identified with these tools. We
could assess whether these treatments are more effective when
"The questions we now need to answer are
whether pharmacological treatment started at the onset of early
warning signs will slow the illness and whether brain plasticity
could be stimulated in a more structured way to delay symptoms that
1. Belleville S, Peters F, Villeneuve S. Predicting Progression to Dementia in Elderly Subjects with
Mild Cognitive Impairment Using Both Cognitive and Neuroimaging
Predictors. Journal of
Alzheimer’s Disease. 38(2):307-318.