Cortical atrophy pattern–based subtyping predicts prognosis of amnestic MCI: an individual-level analysis

Hee Jin Kim, Jong Yun Park, Sang Won Seo, Young Hee Jung, Yeshin Kim, Hyemin Jang, Sung Tae Kim, Joon Kyung Seong, Duk L. Na

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

We categorized patients with amnestic mild cognitive impairment (aMCI) based on cortical atrophy patterns and evaluated whether the prognosis differed across the subtypes. Furthermore, we developed a classifier that learns the cortical atrophy pattern and predicts subtypes at an individual level. A total of 662 patients with aMCI were clustered into 3 subtypes based on cortical atrophy patterns. Of these, 467 patients were followed up for more than 12 months, and the median follow-up duration was 43 months. To predict individual-level subtype, we used a machine learning–based classifier with a 10-fold cross-validation scheme. Patients with aMCI were clustered into 3 subtypes: medial temporal atrophy, minimal atrophy (Min), and parietotemporal atrophy (PT) subtypes. The PT subtype had higher prevalence of APOE ε4 carriers, amyloid PET positivity, and greater risk of dementia conversion than the Min subtype. The accuracy for binary classification was 89.3% (MT vs. Rest), 92.6% (PT vs. Rest), and 86.6% (Min vs. Rest). When we used ensemble model of 3 binary classifiers, the accuracy for predicting the aMCI subtype at an individual level was 89.6%. Patients with aMCI with the PT subtype were more likely to have underlying Alzheimer's disease pathology and showed the worst prognosis. Our classifier may be useful for predicting the prognosis of individual aMCI patients.

Original languageEnglish
Pages (from-to)38-45
Number of pages8
JournalNeurobiology of Aging
Volume74
DOIs
Publication statusPublished - 2019 Feb

Bibliographical note

Funding Information:
This research was supported by a National Research Foundation of Korea grant funded by the Korean government (MSIP) ( NRF-2018R1A1A3A04079255 and NRF-2017R1A2B2005081 ); the Korea Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea ( HI14C2746 , HI18C0335 , and HI18C1629 ); and the Bio & Medical Technology Development Program of the NRF funded by Korean government, MSIP ( 2015M3A9A7029740 ) and Ministry of Science, ICT, & Future Planning ( NRF-2016M3A9A7916996 ); and the Original Technology Research Program for Brain Science through the NRF of Korea funded by the Ministry of Science ICT and Future Planning ( 2017M3C7A1048566 ).

Publisher Copyright:
© 2018

Keywords

  • Alzheimer's disease
  • Classifier
  • Cortical atrophy pattern
  • Mild cognitive impairment

ASJC Scopus subject areas

  • General Neuroscience
  • Ageing
  • Clinical Neurology
  • Developmental Biology
  • Geriatrics and Gerontology

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