Rodolfo G. Gatto1, Joseph R. Duffy1, Rene L. Utianski1, Heather M. Clark1, Hugo Botha1, Mary M. Machulda2, Val J. Lowe3, Keith A. Josephs1, and Jennifer L. Whitwell3
1Division of Neurology, Mayo Clinic at Rochester, Rochester, MN, United States, 2Division of Psychiatry and Psychology, Mayo Clinic at Rochester, Rochester, MN, United States, 3Division of Radiology, Mayo Clinic at Rochester, Rochester, MN, United States
Synopsis
Keywords: Neurodegeneration, Rare disease, Progressive Apraxia of Speech
Progressive apraxia of speech (PAOS)
is a tauopathy characterized by difficulties with motor speech programming and planning.
Grey and white matter (GM & WM) brain regions were interrogated by
diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging
(NODDI). Twenty-three patients with PAOS and 22 matched controls underwent
diffusion MRI. Global WM differences in PAOS were better attained by intracellular
volume fraction (ICVF), whereas GM global differences were better attained by mean
diffusivity (MD) and isotropic volume fraction (isoVF). DTI
and NODDI represent unique aspects of brain tissue microstructure and can be
used as PAOS biomarkers.
INTRODUCTION:
Progressive apraxia of speech (PAOS) is a tauopathy characterized by difficulties
with motor speech programming and planning1. Neurodegeneration
in PAOS targets grey and white matter (GM & WM) microstructure that can be assessed
using diffusion tensor imaging (DTI). However, muti-shell applications, such as
neurite orientation dispersion and density imaging (NODDI) are limited. We hypothesize
that the combination of DTI and NODDI can add further insight into microstructural
damage in PAOS.
METHODS:
Twenty-three
patients with PAOS and 22 age and sex-matched controls were recruited by the
Neurodegenerative Research Group (NRG) at Mayo Clinic and underwent diffusion MRI. DTI
and whole brain tractography were achieved using DSI studio. NODDI was
calculated with MATLAB algorithms2. Outputs were matched using the automated anatomical
parcellation atlas (AAL2) in single-subject space (Figure 1). Separately
for left and right, fractional anisotropy (FA), mean diffusivity (MD) from DTI,
intracellular volume fraction (ICVF), and an isotropic volume fraction (IsoVF) from
NODDI, were calculated from frontal, temporal, and parietal GM ROIs. Corpus callosum,
frontal aslant tract, arcuate fasciculi, inferior longitudinal fasciculi, and thalamic radiations anterior and corticostriatal WM tracts were analyzed.RESULTS:
Global
WM differences between PAOS and controls were observed in ICVF (p<0.001) and
MD (p<0.0053), whereas global GM differences were observed in MD
p<0.0010) and IsoVF (p<0.0005). On averaged WM tracts, MD was
significantly higher (p<0.0001), ICVF was lower (p<0.003), and IsoVF was
higher (p<0.038) in PAOS. Receiver operator characteristic curve (AUROC)
results are presented (Figure 2). CONCLUSIONS:
DTI
and NODDI represent different aspects of brain tissue microstructure, and both show
potential as disease biomarkers in PAOS. Future studies will look at measures
relative to symptom severity, to explore NODDI as a biomarker for earlier
disease detection.Acknowledgements
This study was funded by NIH grants: R01-DC12519, R01-DC14942References
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