ArticleNeuroImage. Clinical2023
Detecting conversion from mild cognitive impairment to Alzheimer's disease using FLAIR MRI biomarkers.
Article in NeuroImage. Clinical, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Machine learning applications in vascular neuroimaging for the diagnosis and prognosis of cognitive impairment and dementia: a systematic review and meta-analysis.Alzheimer's research & therapy · 2025Pooled it
- Machine Learning Driven by Magnetic Resonance Imaging for the Classification of Alzheimer Disease Progression: Systematic Review and Meta-Analysis.JMIR aging · 2024Pooled it
- Effect of Multi-Modal Training in Patients With Mild Cognitive Impairment: A Randomized Controlled Pilot Trial.Medical science monitor : international medical journal of experimental and clinical research · 2026Trial
- Alzheimer's disease-like brain pattern biomarker: capturing risks and predicting disease onset.Molecular psychiatry · 2026Article
- Alzheimer's Disease-Like Brain Pattern Biomarker: Capturing Risks and Predicting Disease Onset.Research square · 2025Article
- The abnormal accumulation of pathological proteins and compensatory functional connectivity enhancement of insula subdivisions in mild cognitive impairment.Frontiers in aging neuroscience · 2025Article
- Altered brain connectivity in mild cognitive impairment is linked to elevated tau and phosphorylated tau, but not to GAP-43 and Amyloid-β measurements: a resting-state fMRI study.Molecular brain · 2024Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Mild cognitive impairment (MCI) is the prodromal phase of Alzheimer's disease (AD) and while it presents as an imperative intervention window, it is difficult to detect which subjects convert to AD (cMCI) and which ones remain stable (sMCI). The objective of this work was to investigate fluid-attenuated inversion recovery (FLAIR) MRI biomarkers and their ability to differentiate between sMCI and cMCI subjects in cross-sectional and longitudinal data. Three types of biomarkers were investigated: volume, intensity and texture. Volume biomarkers included total brain volume, cerebrospinal fluid volume (CSF), lateral ventricular volume, white matter lesion volume, subarachnoid CSF, and grey matter (GM) and white matter (WM), all normalized to intracranial volume. The mean intensity, kurtosis, and skewness of the GM and WM made up the intensity features. Texture features quantified homogeneity and microstructural tissue changes of GM and WM regions. Composite indices were also considered, which are biomarkers that represent an aggregate sum (z-score normalization and summation) of all biomarkers. The FLAIR MRI biomarkers successfully identified high-risk subjects as significant differences (p < 0.05) were found between the means of the sMCI and cMCI groups and the rate of change over time for several individual biomarkers as well as the composite indices for both cross-sectional and longitudinal analyses. Classification accuracy and feature importance analysis showed volume biomarkers to be most predictive, however, best performance was obtained when complimenting the volume biomarkers with the intensity and texture features. Using all the biomarkers, accuracy of 86.2 % and 69.2 % was achieved for normal control-AD and sMCI-cMCI classification respectively. Survival analysis demonstrated that the majority of the biomarkers showed a noticeable impact on the AD conversion probability 4 years prior to conversion. Composite indices were the top performers for all analyses including feature importance, classification, and survival analysis. This demonstrated their ability to summarize various dimensions of disease into single-valued metrics. Significant correlation (p < 0.05) with phosphorylated-tau and amyloid-beta CSF biomarkers was found with all the FLAIR biomarkers. The proposed biomarker system is easily attained as FLAIR is routinely acquired, models are not computationally intensive and the results are explainable, thus making this pipeline easily integrated into clinical workflow.
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