The power of neuroimaging biomarkers for screening frontotemporal dementia
Article first published online: 31 MAR 2014
Copyright © 2014 Wiley Periodicals, Inc.
Human Brain Mapping
Volume 35, Issue 9, pages 4827–4840, September 2014
How to Cite
McMillan, C. T., Avants, B. B., Cook, P., Ungar, L., Trojanowski, J. Q. and Grossman, M. (2014), The power of neuroimaging biomarkers for screening frontotemporal dementia. Hum. Brain Mapp., 35: 4827–4840. doi: 10.1002/hbm.22515
- Issue published online: 18 JUL 2014
- Article first published online: 31 MAR 2014
- Manuscript Accepted: 17 MAR 2014
- Manuscript Received: 31 JAN 2014
- National Institutes of Health. Grant Numbers: AG043503, AG017586, NS044266, AG010124, AG015116
- Wyncote Foundation.
- frontotemporal degeneration;
- Alzheimer's disease;
- statistical power;
Frontotemporal dementia (FTD) is a clinically and pathologically heterogeneous neurodegenerative disease that can result from either frontotemporal lobar degeneration (FTLD) or Alzheimer's disease (AD) pathology. It is critical to establish statistically powerful biomarkers that can achieve substantial cost-savings and increase the feasibility of clinical trials. We assessed three broad categories of neuroimaging methods to screen underlying FTLD and AD pathology in a clinical FTD series: global measures (e.g., ventricular volume), anatomical volumes of interest (VOIs) (e.g., hippocampus) using a standard atlas, and data-driven VOIs using Eigenanatomy. We evaluated clinical FTD patients (N = 93) with cerebrospinal fluid, gray matter (GM) magnetic resonance imaging (MRI), and diffusion tensor imaging (DTI) to assess whether they had underlying FTLD or AD pathology. Linear regression was performed to identify the optimal VOIs for each method in a training dataset and then we evaluated classification sensitivity and specificity in an independent test cohort. Power was evaluated by calculating minimum sample sizes required in the test classification analyses for each model. The data-driven VOI analysis using a multimodal combination of GM MRI and DTI achieved the greatest classification accuracy (89% sensitive and 89% specific) and required a lower minimum sample size (N = 26) relative to anatomical VOI and global measures. We conclude that a data-driven VOI approach using Eigenanatomy provides more accurate classification, benefits from increased statistical power in unseen datasets, and therefore provides a robust method for screening underlying pathology in FTD patients for entry into clinical trials. Hum Brain Mapp 35:4827–4840, 2014. © 2014 Wiley Periodicals, Inc.