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MRI and CSF biomarkers in normal, MCI, and AD subjects: predicting future clinical change
Vemuri P, Wiste HJ, Weigand SD, Shaw LM, Trojanowski JQ, Weiner MW, Knopman DS, Petersen RC et al.. Neurology, 2009-07-01
Topic: Amyloid, tau and blood-test diagnosis
Objective To investigate the relationship between baseline MRI and CSF biomarkers and subsequent change in continuous measures of cognitive and functional abilities in cognitively normal (CN) subjects and patients with amnestic mild cognitive impairment (aMCI) and Alzheimer disease (AD) and to examine the ability of these biomarkers to predict time to conversion from aMCI to AD. Methods Data from the Alzheimer's Disease Neuroimaging Initiative, which consists of CN, aMCI, and AD cohorts with both CSF and MRI, were used. Baseline CSF (t-tau, Abeta(1-42), and p-tau(181P)) and MRI scans were obtained in 399 subjects (109 CN, 192 aMCI, 98 AD). Structural Abnormality Index (STAND) scores, which reflect the degree of AD-like features in MRI, were computed for each subject. Results Change on continuous measures of cognitive and functional performance was modeled as average Clinical Dementia Rating-sum of boxes and Mini-Mental State Examination scores over a 2-year period. STAND was a better predictor of subsequent cognitive/functional change than CSF biomarkers. Single-predictor Cox proportional hazard models for time to conversion from aMCI to AD showed that STAND and log (t-tau/Abeta(1-42)) were both predictive of future conversion. The age-adjusted hazard ratio for an interquartile change (95% confidence interval) of STAND was 2.6 (1.7, 4.2) and log (t-tau/Abeta(1-42)) was 2.0 (1.1, 3.4). Both MRI and CSF provided information about future cognitive change even after adjusting for baseline cognitive performance. Conclusions MRI and CSF provide complimentary predictive information about time to conversion from amnestic mild cognitive impairment to Alzheimer disease and combination of the 2 provides better prediction than either source alone. However, we found that MRI was a slightly better predictor of future clinical/functional decline than the CSF biomarkers tested.
Key findings
- Results Change on continuous measures of cognitive and functional performance was modeled as average Clinical Dementia Rating-sum of boxes and Mini-Mental State Examination scores over a 2-year period.
- Single-predictor Cox proportional hazard models for time to conversion from aMCI to AD showed that STAND and log (t-tau/Abeta(1-42)) were both predictive of future conversion.
- However, we found that MRI was a slightly better predictor of future clinical/functional decline than the CSF biomarkers tested.
Why it matters
In 399 people from the Alzheimer's Disease Neuroimaging Initiative, both an MRI score of Alzheimer-like brain changes (STAND) and a spinal-fluid ratio of total tau to amyloid-beta 1-42 predicted how soon people with amnestic mild cognitive impairment were diagnosed with Alzheimer's disease (hazard ratios 2.6 and 2.0 per interquartile change). The authors conclude the two give complementary information, with the combination predicting better than either alone, and the MRI score was only "slightly" better at predicting two-year decline. This is a group-level prediction study, not a test for individuals and not evidence about treatment or prevention.
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Study details
- Participants399
- Evidence strengthLow
How this study scored 61/100
Published in a leading specialty journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2009 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 399 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 396 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 20.8 citations a year over 19 year(s) since 2009 |
| Impact for its field and year | 5 / 6 | Cited 22.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 50 other studies in this library |
| Still being cited | 2 / 4 | Cited 39 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Clifford R. Jack: h-index 203 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California, San Francisco: institution h-index 1,915 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 19636049) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 61 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Vemuri, P., Wiste, H. J., Weigand, S. D., Shaw, L. M., Trojanowski, J. Q., Weiner, M. W., et al. (2009). MRI and CSF biomarkers in normal, MCI, and AD subjects: predicting future clinical change. Neurology. https://doi.org/10.1212/wnl.0b013e3181af79fb
Vancouver
Vemuri P, Wiste HJ, Weigand SD, Shaw LM, Trojanowski JQ, Weiner MW, et al. MRI and CSF biomarkers in normal, MCI, and AD subjects: predicting future clinical change. Neurology. 2009. doi:10.1212/wnl.0b013e3181af79fb. PMID: 19636049.
BibTeX
@article{vemuri2009-19636049,
author = {Vemuri, P. and Wiste, H. J. and Weigand, S. D. and Shaw, L. M. and Trojanowski, J. Q. and Weiner, M. W. and Knopman, D. S. and Petersen, R. C. and others},
title = {{MRI and CSF biomarkers in normal, MCI, and AD subjects: predicting future clinical change}},
journal = {Neurology},
year = {2009},
doi = {10.1212/wnl.0b013e3181af79fb},
pmid = {19636049},
url = {https://doi.org/10.1212/wnl.0b013e3181af79fb}
}
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