Dementia With Lewy Bodies - Infinitome
Condition: Dementia With Lewy Bodies
MeSH terms: Dementia; Lewy Body Disease
Study type: Observational

Summary: 
      Dementia with Lewy bodies (DLB) is the second most common cause of dementia and is associated
      with parkinsonism, hallucinations, and cognitive fluctuations. Diagnosis is often either
      missed or delayed due to physician lack of familiarity with characteristic features, the
      inability of structural MRI to detect a pathological signature for this condition, and the
      lack of healthcare provider access to "indicative biomarkers" that are either unavailable at
      community clinics or costly due to lack of insurance coverage. The role of resting state
      function MRI (rs-fMRI) as a diagnostic biomarker has been underexplored in this disease. We
      propose using a novel cloud-based automated imaging software processing program that
      identifies abnormal brain networks or connectomes using resting state functional MRI
      (rs-fMRI) and data from the Human Connectome Project (HCP). Furthermore, the imaging protocol
      to capture this data is relatively short (15 minutes) and can be performed at most imaging
      centers, lending potential clinical applicability to this study. We intend to study
      dysfunctional large scale brain networks (LSBNs) in DLB by comparing rs-fMRI imaging data in
      this population with cognitively normal (CN) and mild Alzheimer's disease (AD) subjects from
      the Alzheimer's Disease Neuroimaging Initiative (ADNI)-2/3 database.
    

Detailed description: 
      Omniscient, a for-profit, Sydney, Australia-based company, created the cloud-based software
      Infinitome, a program that utilizes data from the Human Connectome Project (HCP) together
      with machine learning to analyze diffusion tensor and resting-state fMRI imaging data from
      remote sites. The foundation for this imaging tool is based upon the HCP atlas, which has
      also informed prior publications from our group, including the Connectomic Atlas of the Human
      Cerebrum (Baker, Burks, Briggs, Conner, et al. 2018). The Infinitome program creates a
      subject specific version of the Human Connectome Project Multimodal Parcellation (HCP-MMP1)
      atlas using diffusion tractography. Analytics are performed on both diffusion tensor imaging
      and rs-fMRI. Outlier detection using a tangent space connectivity matrix is performed by
      comparing results with a subset of 300 normal HCP subject fMRI samples to determine the range
      of normal correlations for each regions of interest in a large scale brain network which
      include:

        1. Locus coeruleus vs. Nucleus basalis of Meynert

        2. Locus coeruelus vs. Intralaminar nucleus of the thalamus

        3. Nucleus basalis of Meynert vs. Intralaminar nuclei of the thalamus

        4. FST in the vs. Area PH in the lateral occipital lobe

        5. Substantia nigra vs. Caudate nucleus Clinical Measures will be correlated with
           functional connectivity scores to identify relationship between clinical symptoms and
           large scale brain networks in DLB
    

Intervention name(s): Infinitome
Intervention type(s): Procedure
Intervention description(s): All patients will have rs-FMRI images analyzed with the Infinitome cloud-based software processing program.
Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        HealthPartners Neurology Clinic in Saint Paul, MN undergoing care for DLB and subjects
        included in the ADNI database.