TY - JOUR

T1 - Hippocampal shape is predictive for the development of dementia in a normal, elderly population

AU - Achterberg, Hakim C.

AU - van der Lijn, Fedde

AU - den Heijer, Tom

AU - Vernooij, Meike W.

AU - Ikram, M. Arfan

AU - Niessen, Wiro J.

AU - de Bruijne, Marleen

N1 - Copyright © 2013 Wiley Periodicals, Inc.

PY - 2014

Y1 - 2014

N2 - Previous studies have shown that hippocampal volume is an early marker for dementia. We investigated whether hippocampal shape characteristics extracted from MRI scans are predictive for the development of dementia during follow up in subjects who were nondemented at baseline. Furthermore, we assessed whether hippocampal shape provides additional predictive value independent of hippocampal volume. Five hundred eleven brain MRI scans from elderly nondemented participants of a prospective population-based imaging study were used. During the 10-year follow-up period, 52 of these subjects developed dementia. For training and evaluation independent of age and gender, a subset of 50 cases and 150 matched controls was selected. The hippocampus was segmented using an automated method. From the segmentation, the volume was determined and a statistical shape model was constructed. We trained a classifier to distinguish between subjects who developed dementia and subjects who stayed cognitively healthy. For all subjects the a posteriori probability to develop dementia was estimated using the classifier in a cross-validation experiment. The area under the ROC curve for volume, shape, and the combination of both were, respectively, 0.724, 0.743, and 0.766. A logistic regression model showed that adding shape to a model using volume corrected for age and gender increased the global model-fit significantly (P = 0.0063). We conclude that hippocampal shape derived from MRI scans is predictive for dementia before clinical symptoms arise, independent of age and gender. Furthermore, the results suggest that hippocampal shape provides additional predictive value over hippocampal volume and that combining shape and volume leads to better prediction. Hum Brain Mapp, 2013. © 2013 Wiley Periodicals, Inc.

AB - Previous studies have shown that hippocampal volume is an early marker for dementia. We investigated whether hippocampal shape characteristics extracted from MRI scans are predictive for the development of dementia during follow up in subjects who were nondemented at baseline. Furthermore, we assessed whether hippocampal shape provides additional predictive value independent of hippocampal volume. Five hundred eleven brain MRI scans from elderly nondemented participants of a prospective population-based imaging study were used. During the 10-year follow-up period, 52 of these subjects developed dementia. For training and evaluation independent of age and gender, a subset of 50 cases and 150 matched controls was selected. The hippocampus was segmented using an automated method. From the segmentation, the volume was determined and a statistical shape model was constructed. We trained a classifier to distinguish between subjects who developed dementia and subjects who stayed cognitively healthy. For all subjects the a posteriori probability to develop dementia was estimated using the classifier in a cross-validation experiment. The area under the ROC curve for volume, shape, and the combination of both were, respectively, 0.724, 0.743, and 0.766. A logistic regression model showed that adding shape to a model using volume corrected for age and gender increased the global model-fit significantly (P = 0.0063). We conclude that hippocampal shape derived from MRI scans is predictive for dementia before clinical symptoms arise, independent of age and gender. Furthermore, the results suggest that hippocampal shape provides additional predictive value over hippocampal volume and that combining shape and volume leads to better prediction. Hum Brain Mapp, 2013. © 2013 Wiley Periodicals, Inc.

U2 - 10.1002/hbm.22333

DO - 10.1002/hbm.22333

M3 - Journal article

C2 - 24039001

VL - 35

SP - 2359

EP - 2371

JO - Human Brain Mapping

JF - Human Brain Mapping

SN - 1065-9471

IS - 5

ER -