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The Cortical Asymmetry Index for subtyping dementia patients
Agnès Pérez‐Millan, Uma Maria Lal-Trehan Estrada, Neus Falgàs, Núria Guillén, Sergi Borrego‐Écija, Jordi Juncà‐Parella, Beatríz Bosch, Adrià Tort‐Merino et al.. European Radiology, 2025-02-11
Topic: Risk, prevention and care in population studies
A total of 101 FTD patients (64 ± 8 years, 53 men), 230 AD patients (65 ± 10 years, 84 men), and 173 CTR (59 ± 15 years, 67 men) were studied. CAI differentiated FTD, AD, and CTR. It also distinguished the semantic variant primary progressive aphasia (svPPA) from the other FTD phenotypes. In FTD, the CAI increased over time. The cluster analysis identified two subgroups within FTD, characterised by different neurofilament-light (NfL) levels, and two subgroups within AD, with different plasma glial fibrillary acidic protein (GFAP) levels. In AD, CAI correlated with GFAP and Mini-Mental State Examination (MMSE); in FTD, the CAI was associated with NfL levels. The proposed method quantifies asymmetries previously described visually. The CAI could define clinically and biologically meaningful disease subgroups in the differential diagnosis of AD and FTD and its subtypes. CAI could also be of interest in tracking disease progression in FTD. KEY POINTS: Question There is a need to find quantitative metrics from MRI that can identify disease subgroups, and that could be useful for diagnosis and tracking. Findings We propose a Cortical Asymmetry Index that differentiates Alzheimer's disease (AD) from Frontotemporal dementia (FTD), distinguishes FTD subtypes, correlates with NFL and GFAP levels, and monitors FTD progression. Clinical relevance Our proposed index holds the potential to support clinical applications for diagnosis and disease tracking in AD and FTD, using a quantitative summary metric from MRI data. It also contributes to the understanding of these diseases.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Pérez‐Millan, A., Estrada, U. M. L.-T., Falgàs, N., Guillén, N., Borrego‐Écija, S., Juncà‐Parella, J., et al. (2025). The Cortical Asymmetry Index for subtyping dementia patients. European Radiology. https://doi.org/10.1007/s00330-025-11400-y
Vancouver
Pérez‐Millan A, Estrada UML.-T, Falgàs N, Guillén N, Borrego‐Écija S, Juncà‐Parella J, et al. The Cortical Asymmetry Index for subtyping dementia patients. European Radiology. 2025. doi:10.1007/s00330-025-11400-y. PMID: 39934339.
BibTeX
@article{perezmillan2025-39934339,
author = {Pérez‐Millan, Agnès and Estrada, Uma Maria Lal-Trehan and Falgàs, Neus and Guillén, Núria and Borrego‐Écija, Sergi and Juncà‐Parella, Jordi and Bosch, Beatríz and Tort‐Merino, Adrià and others},
title = {{The Cortical Asymmetry Index for subtyping dementia patients}},
journal = {European Radiology},
year = {2025},
doi = {10.1007/s00330-025-11400-y},
pmid = {39934339},
url = {https://doi.org/10.1007/s00330-025-11400-y}
}
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.
Key findings
- A total of 101 FTD patients (64 ± 8 years, 53 men), 230 AD patients (65 ± 10 years, 84 men), and 173 CTR (59 ± 15 years, 67 men) were studied.
- It also distinguished the semantic variant primary progressive aphasia (svPPA) from the other FTD phenotypes.
- The cluster analysis identified two subgroups within FTD, characterised by different neurofilament-light (NfL) levels, and two subgroups within AD, with different plasma glial fibrillary acidic protein (GFAP) levels.
- In AD, CAI correlated with GFAP and Mini-Mental State Examination (MMSE); in FTD, the CAI was associated with NfL levels.
- The proposed method quantifies asymmetries previously described visually.
Why it matters
This cross-sectional study proposed a Cortical Asymmetry Index from MRI that differentiated Alzheimer's disease from frontotemporal dementia, distinguished FTD subtypes, and correlated with blood marker levels. The authors suggest it could help define disease subgroups for diagnosis and track progression in FTD, but it does not test any treatment or prevention.
Study details
- Study designcross-sectional
- Participants101
- Evidence strengthModerate
How this study scored 50/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for effect reported and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (European Radiology) |
| Journal's citation record | 2 / 4 | European Radiology: journal h-index 211 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 101 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) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 4 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Raquel Sánchez‐Valle: h-index 71 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Universitat de Barcelona: institution h-index 1,049 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39934339) |
| Free to read | 2 / 2 | Free to read |
| Total | 50 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1007/s00330-025-11400-y
- PubMed: 39934339
- Original source →
- Free full text: European Radiology →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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