ORIGINAL RESEARCH article
Front. Neurol.
Sec. Dementia and Neurodegenerative Diseases
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1628697
This article is part of the Research TopicBlood, Cerebrospinal Fluid, and Vascular Biomarkers for DementiaView all 21 articles
Predictive Value of Combined DTI-ALPS Index and Creatinine Levels in Mild Cognitive Impairment Associated with Parkinson's Disease
Provisionally accepted
- 1Lianyungang Clinical College of Nanjing Medical University,, Lianyungang, China
- 2The First People's Hospital of Lianyungang, Lianyungang, China
- 3Lianyungang Hospital affiliated to Xuzhou Medical University, Lianyungang, China
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Objective: To identify independent risk factors for Parkinson disease mild cognitive impairment (PD-MCI) and develop a prediction model integrating clinical, blood biomarker, and neuroimaging data, aiding in detection and intervention. Methods: A retrospective study was conducted with 150 PD patients. The PD-MCI group (n=64) and PD with normal cognition (PD-NC, n=86) were identified using the Montreal Cognitive Assessment scale. Data on demographics, motor symptoms, cognitive function, quality of life, blood markers, and diffusion tensor imaging along perivascular spaces (DTI-ALPS) were collected. Univariate analysis identified significant variables, and multivariate logistic regression identified independent risk factors. A nomogram prediction model was developed using R software. Model performance was evaluated using Receiver Operating Characteristic (ROC) curves, bootstrap resampling calibration curves, and decision curve analysis (DCA). Results: Significant differences between the groups were found in levodopa equivalent daily dose (LEDD), PD Quality of Life Questionnaire, creatinine, cystatin C, and ALPS index. Multivariate regression identified higher LEDD (OR=1.01, 95%CI 1.00-1.03, P=0.005) and creatinine levels (OR=1.34, 95%CI 1.10-1.66, P=0.005) as independent risk factors. The nomogram model demonstrated strong discriminatory ability (AUC=0.864, 95%CI 0.807-0.922) and good calibration. DCA showed a significant net benefit within clinical threshold ranges. Conclusion: This study developed a PD-MCI prediction model incorporating DTI-ALPS and clinical blood biomarkers. It confirmed that LEDD and creatinine levels are independent risk factors, with high clinical value for early screening and individualized treatment.
Keywords: DTI-ALPS1, APLS index2, creatinine3, Nomogram4, Prediction model5
Received: 14 May 2025; Accepted: 02 Jul 2025.
Copyright: © 2025 Gao, Li, Ji, Meng, Hu, Chen, Guan and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xinying Guan, The First People's Hospital of Lianyungang, Lianyungang, China
Bingchao Xu, The First People's Hospital of Lianyungang, Lianyungang, China
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