Survival prediction in Amyotrophic lateral sclerosis based on MRI measures and clinical characteristics
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Journal ArticleDate:
2017Access:
openAccessCitation:
Schuster, C., Hardiman, O. & Bede, P., Survival prediction in Amyotrophic lateral sclerosis based on MRI measures and clinical characteristics, BMC Neurol, 17, 1, 2017Download Item:
Abstract:
Background:
Amyotrophic lateral sclerosis (ALS) a highly heterogeneous neurodegenerative condition. Accurate diagnostic, monitoring and prognostic biomarkers are urgently needed both for individualised patient care and clinical trials. A multimodal magnetic resonance imaging study is presented, where MRI measures of ALS-associated brain regions are utilised to predict 18-month survival.
Methods:
A total of 60 ALS patients and 69 healthy controls were included in this study. 20% of the patient sample was utilised as an independent validation sample. Surface-based morphometry and diffusion tensor white matter parameters were used to identify anatomical patterns of neurodegeneration in 80% of the patient sample compared to healthy controls. Binary logistic ridge regressions were carried out to predict 18-month survival based on clinical measures alone, MRI features, and a combination of clinical and MRI data. Clinical indices included age at symptoms onset, site of disease onset, diagnostic delay from first symptom to diagnosis, and physical disability (ALSFRS-r). MRI features included the average cortical thickness of the precentral and paracentral gyri, the average fractional anisotropy, radial-, medial-, and axial diffusivity of the superior and inferior corona radiata, internal capsule, cerebral peduncles and the genu, body and splenium of the corpus callosum.
Results:
Clinical data alone had a survival prediction accuracy of 66.67%, with 62.50% sensitivity and 70.84% specificity. MRI data alone resulted in a prediction accuracy of 77.08%, with 79.16% sensitivity and 75% specificity. The combination of clinical and MRI measures led to a survival prediction accuracy of 79.17%, with 75% sensitivity and 83.34% specificity.
Conclusion:
Quantitative MRI measures of ALS-specific brain regions enhance survival prediction in ALS and should be incorporated in future clinical trial designs.
URI:
https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-017-0854-xhttp://hdl.handle.net/2262/91744
Author's Homepage:
http://people.tcd.ie/hardimaohttp://people.tcd.ie/pbede
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Journal ArticleURI:
https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-017-0854-xhttp://hdl.handle.net/2262/91744
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Series/Report no:
BMC Neurol;17;
1;
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Full text availableKeywords:
Amyotrophic lateral sclerosis (ALS), Magnetic resonance imaging, Biomarker, Diffusion tensor imaging, Cortical thickness, Binary logistic ridge regression, Cross validation, Independent validation, PrognosisSubject (TCD):
NeuroscienceDOI:
http://dx.doi.org/10.1186/s12883-017-0854-xMetadata
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