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Abstract
Purpose
To generate a Korean specific brain template, especially in patients with Alzheimer's disease (AD) by optimizing the voxel-based analysis.
Materials and Methods
Three-dimensional T1-weighted images were obtained from 123 subjects who were 43 cognitively normal subjects and patients with 44 mild cognitive impairment (MCI) and 36 AD. The template and the corresponding aprior maps were created by using the matched pairs approach with considering differences of age, gender and differential diagnosis (DDX). We measured several characteristics in both our and the MNI templates, including in the ventricle size. Also, the fractions of gray matter and white matter voxels normalized by the total intracranial were evaluated.
Results
The high resolution template and the corresponding aprior maps of gray matter, white matter (WM) and CSF were created with the voxel-size of 1 × 1 × 1 mm. Mean distance measures and the ventricle sizes differed between two templates. Our brain template had less gray matter and white matter areas than the MNI template. There were volume differences more in gray matter than in white matter.
Figures and Tables
 | Fig. 1Flowchart for the brain template creation.
In this study, we use two separated steps, VBM5 and TOM.
GM: Gray matter
WM: White matter
CSF: Cerebrospinal Fluid
VBM: Voxel-Based Morphometry
TOM: Template-O-Matic
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 | Fig. 2Measured parameters shown on the images of the smoothed our brain template (a, c) and the MNI-152 template (b, d). The solid lines show the center position (0, 0, 0) in x, y z plane. The upper and lower dotted lines show the length of the SP-IP size and the middle dotted line is the length of the AP-PP line. The vertical lines show the length of the RP-LP line.
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 | Fig. 3Measured distances (mm) of the ventricle area for selecting landmark sites in the MNI-152 template (Upper left and bottom left) and the smoothed our brain template (Upper right and bottom right).
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 | Fig. 4Representative segmented images obtained in a cognitively normal (CN) control subject (upper row), in a patient with mild cognitive impairment (MCI, middle row), and in a patient with Alzheimer's disease (AD, bottom row).
Each subject is a 70 years-old woman.
GM: Gray matter
WM: White matter
CSF: Cerebrospinal Fluid
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 | Fig. 5The created standard brain templates of three-dimensional T1-weighted (a) and the corresponding tissue maps of gray matter(GM, b), white matter (WM, c), andcerebrospinal fluid (CSF, d).
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 | Fig. 6The created standard brain template of three-dimensional T1-weighted images was shown as the axial plane slices.
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 | Fig. 7Beta image volumes in a general linear model; The ages are the coefficients of the third order polynomial
Maps from the second row to the sixth row represent beta image volumes in a general linear model of the standard templates caused by the co-varietiesof age, gender, and DDX.
GM: Gray matter
WM: White matter
CSF: Cerebrospinal Fluid
DDX: Differential diagnosis
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Table 1
Demographic Data of Study Population
Data are listed as the mean ± standard deviation.
CN: Cognitive Normal.
MCI: Mild Cognitive Impairment.
AD: Alzheimer's disease.
#Gender: statistically significant difference between MCI and AD (p = 0.007), but no significant differences between CN and MCI (p = 0.22) or between CN and AD (p = 0.13)
*Age: statistically significant difference between CN and AD (p = 0.0001) and between MCI and AD (p = 0.01), but no significant difference between CN and MCI (p = 0.08)
Table 2
Charateristics of the Two Standard Brain Templates
#Template size (mm) and resolution (mm): X × Y × Z.
*Age, gender and DDX effects were considered in our template (Yes), but not in the MNI (No).
& normalized gray matter or white matter percentage: nGM or nWM equals to the number of GM voxels multipled by 100% devided by the total IC voxels more than 50% of GM or WM, respectively.
DDX: differential diagnosis, GM: gray matter, WM: white matter, IC: Intracranial, AP: anterior point, PC: posterior point, RP-LP: right point-left point, SP-IP: superior point-inferior point
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