Corneal nerve and brain imaging in mild cognitive impairment and dementia

Eiman Al-Janahi; Georgios Ponirakis; Hanadi Al Hamad; Surjith Vattoth; Ahmed Elsotouhy; Ioannis N. Petropoulos; Adnan Khan; Hoda Gad; Mani Chandran; Anoop Sankaranarayanan; Marwan Ramadan; Marwa Elorrabi; Masharig Gadelseed; Rhia Tosino; Priya V. Gawhale; Anjum Arasn; Maryam Alobaidi; Shafi Khan; Pravija Manikoth; Yasmin Hamdi; Susan Osman; Navas Nadukkandiyil; Essa Alsulaiti; Noushad Thodi; Hamad Almuhannadi; Ziyad R. Mahfoud; Ahmed Own; Ashfaq Shuaib; Rayaz A. Malik

doi:10.3233/JAD-200678

Corneal nerve and brain imaging in mild cognitive impairment and dementia

Eiman Al-Janahi, Georgios Ponirakis, Hanadi Al Hamad, Surjith Vattoth, Ahmed Elsotouhy, Ioannis N. Petropoulos, Adnan Khan, Hoda Gad, Mani Chandran, Anoop Sankaranarayanan, Marwan Ramadan, Marwa Elorrabi, Masharig Gadelseed, Rhia Tosino, Priya V. Gawhale, Anjum Arasn, Maryam Alobaidi, Shafi Khan, Pravija Manikoth, Yasmin HamdiSusan Osman, Navas Nadukkandiyil, Essa Alsulaiti, Noushad Thodi, Hamad Almuhannadi, Ziyad R. Mahfoud, Ahmed Own, Ashfaq Shuaib, Rayaz A. Malik

Western Sydney University

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Visual rating of medial temporal lobe atrophy (MTA) is an accepted structural neuroimaging marker of Alzheimer's disease. Corneal confocal microscopy (CCM) is a non-invasive ophthalmic technique that detects neuronal loss in peripheral and central neurodegenerative disorders. Objective: To determine the diagnostic accuracy of CCM for mild cognitive impairment (MCI) and dementia compared to medial temporal lobe atrophy (MTA) rating on MRI. Methods: Subjects aged 60-85 with no cognitive impairment (NCI), MCI, and dementia based on the ICD-10 criteria were recruited. Subjects underwent cognitive screening, CCM, and MTA rating on MRI. Results: 182 subjects with NCI (n = 36), MCI (n = 80), and dementia (n = 66), including AD (n = 19, 28.8%), VaD (n = 13, 19.7%), and mixed AD (n = 34, 51.5%) were studied. CCM showed a progressive reduction in corneal nerve fiber density (CNFD, fibers/mm2) (32.0±7.5 versus 24.5±9.6 and 20.8±9.3, p < 0.0001), branch density (CNBD, branches/mm2) (90.9±46.5 versus 59.3±35.7 and 53.9±38.7, p < 0.0001), and fiber length (CNFL, mm/mm2) (22.9±6.1 versus 17.2±6.5 and 15.8±7.4, p < 0.0001) in subjects with MCI and dementia compared to NCI. The area under the ROC curve (95% CI) for the diagnostic accuracy of CNFD, CNBD, CNFL compared to MTA-right and MTA-left for MCI was 78% (67-90%), 82% (72-92%), 86% (77-95%) versus 53% (36-69%) and 40% (25-55%), respectively, and for dementia it was 85% (76-94%), 84% (75-93%), 85% (76-94%) versus 86% (76-96%) and 82% (72-92%), respectively. Conclusion: The diagnostic accuracy of CCM, a non-invasive ophthalmic biomarker of neurodegeneration, was high and comparable with MTA rating for dementia but was superior to MTA rating for MCI.

Original language	English
Pages (from-to)	1533-1543
Number of pages	11
Journal	Journal of Alzheimer's Disease
Volume	77
Issue number	4
DOIs	https://doi.org/10.3233/JAD-200678
Publication status	Published - 2020

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© 2020-IOS Press and the authors. All rights reserved. This article is published online with Open Access and distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC 4.0 (https://creativecommons.org/licenses/by-nc/4.0/).

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10.3233/JAD-200678

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Al-Janahi, E., Ponirakis, G., Al Hamad, H., Vattoth, S., Elsotouhy, A., Petropoulos, I. N., Khan, A., Gad, H., Chandran, M., Sankaranarayanan, A., Ramadan, M., Elorrabi, M., Gadelseed, M., Tosino, R., Gawhale, P. V., Arasn, A., Alobaidi, M., Khan, S., Manikoth, P., ... Malik, R. A. (2020). Corneal nerve and brain imaging in mild cognitive impairment and dementia. Journal of Alzheimer's Disease, 77(4), 1533-1543. https://doi.org/10.3233/JAD-200678

@article{521c4cf84ce14adebed5229bef60a0ac,

title = "Corneal nerve and brain imaging in mild cognitive impairment and dementia",

abstract = "Background: Visual rating of medial temporal lobe atrophy (MTA) is an accepted structural neuroimaging marker of Alzheimer's disease. Corneal confocal microscopy (CCM) is a non-invasive ophthalmic technique that detects neuronal loss in peripheral and central neurodegenerative disorders. Objective: To determine the diagnostic accuracy of CCM for mild cognitive impairment (MCI) and dementia compared to medial temporal lobe atrophy (MTA) rating on MRI. Methods: Subjects aged 60-85 with no cognitive impairment (NCI), MCI, and dementia based on the ICD-10 criteria were recruited. Subjects underwent cognitive screening, CCM, and MTA rating on MRI. Results: 182 subjects with NCI (n = 36), MCI (n = 80), and dementia (n = 66), including AD (n = 19, 28.8%), VaD (n = 13, 19.7%), and mixed AD (n = 34, 51.5%) were studied. CCM showed a progressive reduction in corneal nerve fiber density (CNFD, fibers/mm2) (32.0±7.5 versus 24.5±9.6 and 20.8±9.3, p < 0.0001), branch density (CNBD, branches/mm2) (90.9±46.5 versus 59.3±35.7 and 53.9±38.7, p < 0.0001), and fiber length (CNFL, mm/mm2) (22.9±6.1 versus 17.2±6.5 and 15.8±7.4, p < 0.0001) in subjects with MCI and dementia compared to NCI. The area under the ROC curve (95% CI) for the diagnostic accuracy of CNFD, CNBD, CNFL compared to MTA-right and MTA-left for MCI was 78% (67-90%), 82% (72-92%), 86% (77-95%) versus 53% (36-69%) and 40% (25-55%), respectively, and for dementia it was 85% (76-94%), 84% (75-93%), 85% (76-94%) versus 86% (76-96%) and 82% (72-92%), respectively. Conclusion: The diagnostic accuracy of CCM, a non-invasive ophthalmic biomarker of neurodegeneration, was high and comparable with MTA rating for dementia but was superior to MTA rating for MCI.",

author = "Eiman Al-Janahi and Georgios Ponirakis and {Al Hamad}, Hanadi and Surjith Vattoth and Ahmed Elsotouhy and Petropoulos, {Ioannis N.} and Adnan Khan and Hoda Gad and Mani Chandran and Anoop Sankaranarayanan and Marwan Ramadan and Marwa Elorrabi and Masharig Gadelseed and Rhia Tosino and Gawhale, {Priya V.} and Anjum Arasn and Maryam Alobaidi and Shafi Khan and Pravija Manikoth and Yasmin Hamdi and Susan Osman and Navas Nadukkandiyil and Essa Alsulaiti and Noushad Thodi and Hamad Almuhannadi and Mahfoud, {Ziyad R.} and Ahmed Own and Ashfaq Shuaib and Malik, {Rayaz A.}",

year = "2020",

doi = "10.3233/JAD-200678",

language = "English",

volume = "77",

pages = "1533--1543",

journal = "Journal of Alzheimer's Disease",

issn = "1387-2877",

publisher = "IOS Press",

number = "4",

}

Al-Janahi, E, Ponirakis, G, Al Hamad, H, Vattoth, S, Elsotouhy, A, Petropoulos, IN, Khan, A, Gad, H, Chandran, M, Sankaranarayanan, A, Ramadan, M, Elorrabi, M, Gadelseed, M, Tosino, R, Gawhale, PV, Arasn, A, Alobaidi, M, Khan, S, Manikoth, P, Hamdi, Y, Osman, S, Nadukkandiyil, N, Alsulaiti, E, Thodi, N, Almuhannadi, H, Mahfoud, ZR, Own, A, Shuaib, A & Malik, RA 2020, 'Corneal nerve and brain imaging in mild cognitive impairment and dementia', Journal of Alzheimer's Disease, vol. 77, no. 4, pp. 1533-1543. https://doi.org/10.3233/JAD-200678

TY - JOUR

T1 - Corneal nerve and brain imaging in mild cognitive impairment and dementia

AU - Al-Janahi, Eiman

AU - Ponirakis, Georgios

AU - Al Hamad, Hanadi

AU - Vattoth, Surjith

AU - Elsotouhy, Ahmed

AU - Petropoulos, Ioannis N.

AU - Khan, Adnan

AU - Gad, Hoda

AU - Chandran, Mani

AU - Sankaranarayanan, Anoop

AU - Ramadan, Marwan

AU - Elorrabi, Marwa

AU - Gadelseed, Masharig

AU - Tosino, Rhia

AU - Gawhale, Priya V.

AU - Arasn, Anjum

AU - Alobaidi, Maryam

AU - Khan, Shafi

AU - Manikoth, Pravija

AU - Hamdi, Yasmin

AU - Osman, Susan

AU - Nadukkandiyil, Navas

AU - Alsulaiti, Essa

AU - Thodi, Noushad

AU - Almuhannadi, Hamad

AU - Mahfoud, Ziyad R.

AU - Own, Ahmed

AU - Shuaib, Ashfaq

AU - Malik, Rayaz A.

PY - 2020

Y1 - 2020

N2 - Background: Visual rating of medial temporal lobe atrophy (MTA) is an accepted structural neuroimaging marker of Alzheimer's disease. Corneal confocal microscopy (CCM) is a non-invasive ophthalmic technique that detects neuronal loss in peripheral and central neurodegenerative disorders. Objective: To determine the diagnostic accuracy of CCM for mild cognitive impairment (MCI) and dementia compared to medial temporal lobe atrophy (MTA) rating on MRI. Methods: Subjects aged 60-85 with no cognitive impairment (NCI), MCI, and dementia based on the ICD-10 criteria were recruited. Subjects underwent cognitive screening, CCM, and MTA rating on MRI. Results: 182 subjects with NCI (n = 36), MCI (n = 80), and dementia (n = 66), including AD (n = 19, 28.8%), VaD (n = 13, 19.7%), and mixed AD (n = 34, 51.5%) were studied. CCM showed a progressive reduction in corneal nerve fiber density (CNFD, fibers/mm2) (32.0±7.5 versus 24.5±9.6 and 20.8±9.3, p < 0.0001), branch density (CNBD, branches/mm2) (90.9±46.5 versus 59.3±35.7 and 53.9±38.7, p < 0.0001), and fiber length (CNFL, mm/mm2) (22.9±6.1 versus 17.2±6.5 and 15.8±7.4, p < 0.0001) in subjects with MCI and dementia compared to NCI. The area under the ROC curve (95% CI) for the diagnostic accuracy of CNFD, CNBD, CNFL compared to MTA-right and MTA-left for MCI was 78% (67-90%), 82% (72-92%), 86% (77-95%) versus 53% (36-69%) and 40% (25-55%), respectively, and for dementia it was 85% (76-94%), 84% (75-93%), 85% (76-94%) versus 86% (76-96%) and 82% (72-92%), respectively. Conclusion: The diagnostic accuracy of CCM, a non-invasive ophthalmic biomarker of neurodegeneration, was high and comparable with MTA rating for dementia but was superior to MTA rating for MCI.

AB - Background: Visual rating of medial temporal lobe atrophy (MTA) is an accepted structural neuroimaging marker of Alzheimer's disease. Corneal confocal microscopy (CCM) is a non-invasive ophthalmic technique that detects neuronal loss in peripheral and central neurodegenerative disorders. Objective: To determine the diagnostic accuracy of CCM for mild cognitive impairment (MCI) and dementia compared to medial temporal lobe atrophy (MTA) rating on MRI. Methods: Subjects aged 60-85 with no cognitive impairment (NCI), MCI, and dementia based on the ICD-10 criteria were recruited. Subjects underwent cognitive screening, CCM, and MTA rating on MRI. Results: 182 subjects with NCI (n = 36), MCI (n = 80), and dementia (n = 66), including AD (n = 19, 28.8%), VaD (n = 13, 19.7%), and mixed AD (n = 34, 51.5%) were studied. CCM showed a progressive reduction in corneal nerve fiber density (CNFD, fibers/mm2) (32.0±7.5 versus 24.5±9.6 and 20.8±9.3, p < 0.0001), branch density (CNBD, branches/mm2) (90.9±46.5 versus 59.3±35.7 and 53.9±38.7, p < 0.0001), and fiber length (CNFL, mm/mm2) (22.9±6.1 versus 17.2±6.5 and 15.8±7.4, p < 0.0001) in subjects with MCI and dementia compared to NCI. The area under the ROC curve (95% CI) for the diagnostic accuracy of CNFD, CNBD, CNFL compared to MTA-right and MTA-left for MCI was 78% (67-90%), 82% (72-92%), 86% (77-95%) versus 53% (36-69%) and 40% (25-55%), respectively, and for dementia it was 85% (76-94%), 84% (75-93%), 85% (76-94%) versus 86% (76-96%) and 82% (72-92%), respectively. Conclusion: The diagnostic accuracy of CCM, a non-invasive ophthalmic biomarker of neurodegeneration, was high and comparable with MTA rating for dementia but was superior to MTA rating for MCI.

UR - https://hdl.handle.net/1959.7/uws:62587

U2 - 10.3233/JAD-200678

DO - 10.3233/JAD-200678

M3 - Article

SN - 1387-2877

VL - 77

SP - 1533

EP - 1543

JO - Journal of Alzheimer's Disease

JF - Journal of Alzheimer's Disease

IS - 4

ER -

Corneal nerve and brain imaging in mild cognitive impairment and dementia

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