Automated voxel- and region-based analysis of gray matter and cerebrospinal fluid space in primary dementia disorders.

Egger, Karl; Rau, Alexander; Yang, Shan; Klöppel, Stefan; Abdulkadir, Ahmed; Kellner, Elias; Frings, Lars; Hellwig, Sabine; Urbach, Horst (2020). Automated voxel- and region-based analysis of gray matter and cerebrospinal fluid space in primary dementia disorders. Brain research, 1739, p. 146800. Elsevier 10.1016/j.brainres.2020.146800

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PURPOSE Previous studies showed voxel-based volumetry as a helpful tool in detecting pathologic brain atrophy. Aim of this study was to investigate whether the inclusion of CSF volume improves the imaging based diagnostic accuracy using combined automated voxel- and region-based volumetry. METHODS In total, 120 individuals (30 healthy elderly, 30 frontotemporal dementia (FTD), 30 Alzheimer's dementia (AD) and 30 Lewy body dementia (LBD) patients) were analyzed with voxel-based morphometry and compared to a reference group of 360 healthy elderly controls. Abnormal GM and CSF volumes were visualized via z-scores. Volumetric results were finally evaluated by ROC analyses. RESULTS Based on the volume of abnormal GM and CSF voxels high accuracy was shown in separating dementia from normal ageing (AUC 0.93 and 0.91, respectively) within 5 different brain regions per hemisphere (frontal, medial temporal, temporal, parietal, occipital). Accuracy for separating FTD and AD was higher based on CSF volume (FTD: AUC 0.80 vs. 0.75 in frontal regions; AD: AUC 0.78 vs. 0.68 in parietal regions based on CSF and GM respectively). CONCLUSIONS Differentiation of dementia patients from normal ageing persons shows high accuracy when based on automatic volumetry alone. Evaluating volumes of abnormal CSF performed better than volumes of abnormal GM, especially in AD and FTD patients.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > University Psychiatric Services > University Hospital of Geriatric Psychiatry and Psychotherapy

UniBE Contributor:

Klöppel, Stefan and Abdulkadir, Ahmed


600 Technology > 610 Medicine & health








Katharina Klink

Date Deposited:

06 May 2020 15:49

Last Modified:

18 May 2020 01:33

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Alzheimer’s disease Dementia Frontotemporal dementia Lewy body dementia Machine learning Volumetry




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