MARBLE: An in vivo MRI marker of limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC).
Authors
Affiliations (5)
Affiliations (5)
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Illinois, USA.
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA.
- Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA.
- Department of Diagnostic Radiology, Rush University Medical Center, Chicago, Illinois, USA.
Abstract
Limbic-predominant age-related transactive response DNA binding protein 43 kDa encephalopathy neuropathologic change (LATE-NC) is common in older adults, yet definitive diagnosis is only possible at autopsy. This work developed a fully automated in vivo marker of LATE-NC named MARBLE (MARker of Brain LatE) by applying machine learning methods on brain magnetic resonance imaging (MRI) and neuropathology data from 918 community-based older adults. Testing MARBLE in an independent group of older adults, with ante mortem intervals between MRI and death of < 3 years, achieved an area under the curve = 0.92 for in vivo prediction of LATE-NC. Moreover, a higher MARBLE score was associated with higher LATE-NC stages (β = 0.083, 95% confidence interval = [0.053, 0.113], p < 10<sup>-4</sup>), and a lower level and accelerated decline of cognition, with the strongest effects observed in episodic and semantic memory, and perceptual speed (p < 10<sup>-4</sup>). MARBLE is an automated in vivo MRI-based marker of LATE-NC holding significant promise for enhancing diagnosis, refining clinical trial enrollment, and advancing targeted therapeutic approaches.