Transmission studies in animal models have identified four strains of sporadic Creutzfeldt-Jakob disease (sCJD). Using a data-driven approach, we aim to identify subgroups of sCJD patients with distinct diffusion-weighted MRI (DWI) abnormality patterns, and test their association with disease strains. We used an unsupervised machine-learning algorithm named Subtype and Stage Inference, that identified 5 clusters of patients each having a distinct pattern of DWI abnormality progression: one had initial involvement of the parieto-frontal cortex; two started with subcortical regions (striatum, thalamus and cerebellum); and two had cortical and limbic regions affected early. Data-driven subgroups were significantly associated with sCJD strains.
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