Beyond Group Classification: Probabilistic Differential Diagnosis of Frontotemporal Dementia and Alzheimer’s Disease with MRI and CSF Biomarkers.

Agnes Perez-Millan,Bertrand Thirion,Neus Falgas,Sergi Borrego-Ecija,Beatriz Bosch,Jordi Junca-Parella,Adria Tort-Merino,Jordi Sarto,Josep Maria Auge,Anna Antonell,Nuria Bargallo,Mircea Balasa,Albert Llado,Raquel Sanchez-Valle, Rose Sala Llonch

NEUROBIOLOGY OF AGING（2024）

Univ Paris Saclay | Biochemistry and Molecular Genetics Department | Univ Barcelona

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Abstract

Neuroimaging and fluid biomarkers are used to differentiate frontotemporal dementia (FTD) from Alzheimer’s disease (AD). We implemented a machine learning algorithm that provides individual probabilistic scores based on magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) data. We investigated whether combining MRI and CSF levels could improve the diagnosis confidence. 215 AD patients, 103 FTD patients, and 173 healthy controls (CTR) were studied. With MRI data, we obtained an accuracy of 82% for AD vs. FTD. A total of 74% of FTD and 73% of AD participants have a high probability of accurate diagnosis. Adding CSF-NfL and 14-3-3 levels improved the accuracy and the number of patients in the confidence group for differentiating FTD from AD. We obtain individual diagnostic probabilities with high precision to address the problem of confidence in the diagnosis. We suggest when MRI, CSF, or the combination are necessary to improve the FTD and AD diagnosis. This algorithm holds promise towards clinical applications as support to clinical findings or in settings with limited access to expert diagnoses.

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Key words

Alzheimer's disease,frontotemporal dementia,magnetic resonance imaging,machine learning,CSF biomarkers,individual probability

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