Prediction of Treatment Response to Donepezil using Automated Hippocampal Subfields Volumes Segmentation in Patients with Mild Alzheimer’s Disease
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Previous studies reported some relationships between donepezil treatment and hippocampus in Alzheimer’s disease (AD). However, due to methodological limitations, their close relationships remain unclear. The aim of this study is to predict treatment response to donepezil by utilizing the automated segmentation of hippocampal subfields volumes (ASHS) in AD. Sixty four AD patients were prescribed with donepezil and were followed up for 24 weeks. Cognitive function was measured to assess whether there was a response from the donepezil treatment. ASHS was implemented on non-responder (NR) and responder (TR) groups, and receiver operator characteristic (ROC) analysis was conducted to evaluate the sensitivity, specificity, and accuracy of hippocampal subfields in predicting response to donepezil. The left total hippocampus and the CA1 area of the NR were significantly smaller than those of the TR group. The ROC curve analysis showed the left CA1 volumes showed highest area under curve (AUC) of 0.85 with a sensitivity of 88.0%, a specificity of 74.0% in predicting treatment response to donepezil treatment. We expect that hippocampal subfields volume measurements that predict treatment responses to current AD drugs will enable more evidence-based, individualized prescription of medications that will lead to more favorable treatment outcomes.
Abstract
Previous studies reported some relationships between donepezil treatment and hippocampus in Alzheimer’s disease (AD). However, due to methodological limitations, their close relationships remain unclear. The aim of this study is to predict treatment response to donepezil by utilizing the automated segmentation of hippocampal subfields volumes (ASHS) in AD. Sixty four AD patients were prescribed with donepezil and were followed up for 24 weeks. Cognitive function was measured to assess whether there was a response from the donepezil treatment. ASHS was implemented on non-responder (NR) and responder (TR) groups, and receiver operator characteristic (ROC) analysis was conducted to evaluate the sensitivity, specificity, and accuracy of hippocampal subfields in predicting response to donepezil. The left total hippocampus and the CA1 area of the NR were significantly smaller than those of the TR group. The ROC curve analysis showed the left CA1 volumes showed highest area under curve (AUC) of 0.85 with a sensitivity of 88.0%, a specificity of 74.0% in predicting treatment response to donepezil treatment. We expect that hippocampal subfields volume measurements that predict treatment responses to current AD drugs will enable more evidence-based, individualized prescription of medications that will lead to more favorable treatment outcomes.
참고문헌 (34)
- National Institute for Clinical Excellence (NICE)., "Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer’s disease", Technology appraisal guidance, 217~ (2011)
- Burns A, "Defining treatment response to donepezil in Alzheimer’s disease: responder analysis of patient-level data from randomized, placebo-controlled studies", Drugs Aging, 25, pp.707~714 (2008)
- Braga ILS, "Effect of APOE and CHRNA7 genotypes on the cognitive response to cholinesterase inhibitor treatment at different stages of Alzheimer’s disease", Am J Alzheimers Dis Other Dement, 30, pp.139~144 (2015)
- Perera G, "Factors associated with response to acetylcholinesterase inhibition in dementia: a cohort study from a secondary mental health care case register in London", PLoS One, 9, pp.e109484~ (2014)
- Zuckerman IH, "Racial and ethnic disparities in the treatment of dementia among medicare beneficiaries", J Gerontol B Psychol Sci Soc Sci, 63, pp.S328~S333 (2008)
- Csernansky JG, "Neuroanatomical predictors of response to donepezil therapy in patients with dementia", Arch Neurol, 62, pp.1718~1722 (2005)
- Wang L, "Donepezil treatment and changes in hippocampal structure in very mild Alzheimer disease", Arch Neurol, 67, pp.99~106 (2010)
- Lim HK, "Automated hippocampal subfield segmentation in amnestic mild cognitive impairments", Dement Geriatr Cogn Disord, 33, pp.327~333 (2012)
- McKhann GM, "The diagnosis of dementia due to Alzheimer’s disease : Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease", Alzheimers Dement, 7, pp.263~269 (2011)
- Morris JC, "Clinical dementia rating: a reliable and valid diagnostic and staging measure for dementia of the Alzheimer type", Int Psychogeriatr, 9(Suppl 1), pp.173~176 (1997)
- Wallin AK, "Can CSF biomarkers or pre‐treatment progression rate predict response to cholinesterase inhibitor treatment in Alzheimer’s disease?", Int J Geriatr Psychiatry, 24, pp.638~647 (2009)
- Yushkevich PA, "Automated volumetry and regional thickness analysis of hippocampal subfields and medial temporal cortical structures in mild cognitive impairment", Hum Brain Mapp, 36, pp.258~287 (2015)
- Shi F, "Hippocampal volume and asymmetry in mild cognitive impairment and Alzheimer’s disease : meta‐analyses of MRI studies", Hippocampus, 19, pp.1055~1064 (2009)
- Tanaka Y, "Atrophy of the substantia innominata on magnetic resonance imaging predicts response to donepezil treatment in Alzheimer’s disease patients", Dement Geriatr Cogn Disord, 16, pp.119~125 (2003)
- Csernansky JG, "NEuroanatomical predictors of response to donepezil therapy in patients with dementia", Arch Neurol, 62, pp.1718~1722 (2005)
- Connelly PJ, "Predicting the outcome of cholinesterase inhibitor treatment in Alzheimer’s disease", J Neurol Neurosurg Psychiatry, 76, pp.320~324 (2005)
- Kanetaka H, "Prediction of response to donepezil in Alzheimer’s disease : combined MRI analysis of the substantia innominata and SPECT measurement of cerebral perfusion", Nucl Med Commun, 29, pp.568~573 (2008)
- Bobinski M, "Neuronal and volume loss in CA1 of the hippocampal formation uniquely predicts duration and severity of Alzheimer disease", Brain Res, 805, pp.267~269 (1998)
- West MJ, "Differences in the pattern of hippocampal neuronal loss in normal ageing and Alzheimer’s disease", Lancet, 344, pp.769~772 (1994)
- Seeger T, "M2 muscarinic acetylcholine receptor knock-out mice show deficits in behavioral flexibility, working memory, and hippocampal plasticity", J Neurosci, 24, pp.10117~10127 (2004)
- Shinoe T, "Modulation of synaptic plasticity by physiological activation of M1 muscarinic acetylcholine receptors in the mouse hippocampus", J Neurosci, 25, pp.11194~11200 (2005)
- Martin S, "The rodent hippocampus and spatial memory : from synapses to systems", Cell Mol Life Sci, 64, pp.401~431 (2007)
- Daugherty AM, "Age differences in hippocampal subfield volumes from childhood to late adulthood", Hippocampus, 26, pp.220~228 (2016)
- de Flores R, "Structural imaging of hippocampal subfields in healthy aging and Alzheimer’s disease", Neuroscience, 309, pp.29~50 (2015)
- de Flores R, "Effects of age and Alzheimer’s disease on hippocampal subfields : comparison between manual and FreeSurfer volumetry", Human Brain Mapp, 36, pp.463~474 (2015)
- La Joie R, "Hippocampal subfield volumetry in mild cognitive impairment, Alzheimer’s disease and semantic dementia", NeuroImage Clin, 3, pp.155~162 (2013)
- Raz N, "Volume of the hippocampal subfields in healthy adults : differential associations with age and a pro-inflammatory genetic variant", Brain Struct Funct, 220, pp.2663~2674 (2015)
- Voineskos AN, "Hippocampal(subfield)volume and shape in relation to cognitive performance across the adult lifespan", Human Brain Mapp, 36, pp.3020~3037 (2015)
- Wisse LE, "Hippocampal subfield volumes at 7T in early Alzheimer’s disease and normal aging", Neurobiol Aging, 35, pp.2039~2045 (2014)
- Csernansky JG, "Preclinical detection of Alzheimer’s disease : hippocampal shape and volume predict dementia onset in the elderly", Neuroimage, 25, pp.783~792 (2005)
- Khan W, "Automated hippocampal subfield measures as predictors of conversion from mild cognitive impairment to alzheimer’s disease in two independent cohorts", Brain Topogr, 28, pp.746~759 (2015)
- Rogers S, "A 24-week, double-blind, placebo-controlled trial of donepezil in patients with Alzheimer’s disease", Neurology, 50, pp.136~145 (1998)
- Feldman H, "A 24-week, randomized, double-blind study of donepezil in moderate to severe Alzheimer’s disease", Neurology, 57, pp.613~620 (2001)
- Homma A, "Donepezil treatment of patients with severe Alzheimer’s disease in a Japanese population: results from a 24-week, double-blind, placebo-controlled, randomized trial", Dement Geriatr Cogn Disord, 25, pp.399~407 (2008)
