Postmortem studies on patients with Alzheimer’s disease (AD) have confirmed that the dorsal raphe nucleus (DRN) in the brainstem is the first brain structure affected in the earliest stage of AD. The present study examined the brainstem in the early stage of AD using magnetic resonance (MR) imaging. T1-weighted MR images of the brains of 81 subjects were obtained from the publicly available Open Access Series of Imaging Studies (OASIS) database, including 27 normal control (NC) subjects, 27 patients with very mild AD (AD-VM) and 27 patients with mild AD (AD-M). The brainstem was interactively segmented from the MR images using ITK-SNAP. The present voxel-based morphometry (VBM) study was designed to investigate the brainstem differences between the AD-VM/AD-M groups and the NC group. The results showed bilateral loss in the pons and the left part of the midbrain in the AD-M group compared to the NC group. The AD-M group showed greater loss in the left midbrain than the AD-VM group (PFWEcorrected < 0.05). The results revealed that brainstem atrophy occurs in the early stages of AD (Clinical Dementia Rating = 0.5 and 1.0). Most of these findings were also investigated in a multicenter dataset. This is the first VBM study that provides evidence of brainstem alterations in the early stage of AD.
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This study was founded by the Science and Technology Cooperation Direction Project of Hainan Key Research and Development Plan (grant number ZDYD2019207) and National Natural Science Foundation of China (grant numbers 81171304, 81201150 and 81500924). It was also supported by Sanya Key Laboratory Construction (grant number L1232) and Natural Science Foundation of Hainan Province of China (grant number 20158306). The OASIS dataset used in this work was funded by grants (P50 AG05681, P01 AG03991, R01 AG021910, P50 MH071616, U24 RR021382, R01 MH56584). Data used in preparation of this article were obtained from the ADNI database (adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing this report. A complete listing of ADNI investigators can be found at http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf.
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Ji, X., Wang, H., Zhu, M. et al. Brainstem atrophy in the early stage of Alzheimer’s disease: a voxel-based morphometry study. Brain Imaging and Behavior 15, 49–59 (2021). https://doi.org/10.1007/s11682-019-00231-3
- Magnetic resonance imaging
- Voxel-based morphometry
- Alzheimer’s disease