Diagnostic Validity of an Automated Probabilistic Tractography in Amnestic Mild Cognitive Impairment
Wonsang Jung 1, Yoo Hyun Um 2, Dong Woo Kang 3, Chang Uk Lee 3, Hyun kook Lim 2*
1Department of Radiology, St. Vincent Hospital Catholic University of KOREA, 2Department of Psychiatry, St. Vincent Hospital Catholic University of KOREA, 3Department of Psychiatry, Seoul St Mary's Hospital, Catholic University of KOREA
Received: November 4, 2016; Revised: November 15, 2016; Accepted: November 22, 2016; Published online: November 22, 2016.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objective
Although several prior works showed the white matter (WM)integrity changes in amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease, it is still unclear the diagnostic accuracy of the WM integrity measurements using diffusion tensor imaging (DTI)in discriminating aMCI from normal controls. The aim of this study is to explore diagnostic validity of whole brain automated probabilistic tractography in discriminating aMCI from normal controls.
Methods
One hundred two subjects (50 aMCI and 52 normal controls) were included and underwent DTI scans. Whole brain WM tracts were reconstructed with automated probabilistic tractography. Fractional anisotropy (FA) and mean diffusivity (MD) values of the memory related WM tracts were measured and compared between the aMCI and the normal control groups. In addition, the diagnostic validities of these WM tracts were evaluated.
Results
Decreased FA and increased MD values of memory related WM tracts were observed in the aMCI group compared with the control group. Among FA and MD value of each tract, the FA value of left cingulum angular bundle showed the highest area under curve (AUC) of 0.85 with a sensitivity of 88.2%, a specificity of 76.9%. in differentiating MCI patients from control subjects. Furthermore, the combination FA values of WM integrity measures of memory related WM tracts showed AUC value of 0.98, a sensitivity of 96%, a specificity of 94.2%.
Conclusions
Our results with good diagnostic validity of WM integrity measurements suggest DTI might be promising neuroimaging tool for early detection of aMCI and AD patients.
Keywords: mild cognitive impairment, diffusion tensor imaging, validity, diagnosis


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