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REGIONAL NEUROANATOMICAL SUBTYPES IN SUBJECTIVE COGNITIVE DECLINE: A CLUSTERING ANALYSIS IN THE FACEHBI COHORT
Abstract
Aims
Subjective cognitive decline (SCD) is associated with increased risk of mild cognitive impairment (MCI) and dementia such as Alzheimer’s disease (AD). Our aim was to determine differential neuroanatomic subtypes that might serve as a predictive biomarker of cognitive decline using a data-driven approach.
Methods
147 individuals with SCD from the FACEHBI cohort who underwent a 1.5T brain MRI at baseline visit were included. Cortical thickness from 68 regions was estimated using Freesurfer 6.0.1. After reducing dimensionality using a variance filter, Ward's hierarchical agglomerative analysis was conducted to cluster individuals based on their cortical thickness. Differences in clinical variables, APOE-e4 status and Aβ deposition assessed using FBB-PET were examined between subtypes.
Results
Three neuroanatomical subtypes were identified. The first subtype showed increased cortical thickness (non-atrophy subtype, n=49) in comparison to the others. Between these two subtypes, one showed reduced thickness in the lateral temporal (temporal subtype, n=47) and the other in the cingulate/parahippocampal cortex (cingulate subtype, n=51). Subjects in these two subtypes were significantly older and had worse executive function performance. The cingulate subtype also showed a trend towards higher rates of conversion to MCI during follow-up. No significant differences were found for the other variables examined.
Conclusions
SCD individuals showed three distinct cortical subtypes: a non-atrophy subtype and a temporal and cingulate subtypes characterized by older age and worse cognitive performance. The cingulate subtype also showed higher rates of conversion to MCI. These findings may contribute to reveal the earliest neurodegenerative processes underlying AD and to identify those at risk of conversion.