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Hippocampal atrophy on MRI in frontotemporal lobar degeneration and Alzheimer's disease
L A van de Pol1, A Hensel, W M van der Flier
1VUMC, Department of Neurology, PO Box 7057, 1007 MB Amsterdam, The Netherlands. L.vandepol@vumc.nl
Background:
Hippocampal atrophy on magnetic resonance imaging (MRI) is an early characteristic of Alzheimer's disease. However, hippocampal atrophy may also occur in other dementias, such as frontotemporal lobar degeneration (FTLD).
Objective:
To investigate hippocampal atrophy on MRI in FTLD and its three clinical subtypes, in comparison with Alzheimer's disease, using volumetry and a visual rating scale.
Methods:
42 patients with FTLD (17 frontotemporal dementia, 13 semantic dementia, and 12 progressive non-fluent aphasia), 103 patients with Alzheimer's disease, and 73 controls were included. Hippocampal volumetry and the easily applicable medial temporal lobe atrophy (MTA) rating scale were applied to assess hippocampal atrophy.
Results:
Multivariate analysis of variance for repeated measures showed an effect of diagnostic group on hippocampal volume. There was a significant diagnosis by side (left v right) interaction. Both FTLD and Alzheimer's disease showed hippocampal atrophy compared with controls. Results of the visual MTA rating scale confirmed these findings. Within the FTLD subtypes there were marked differences in hippocampal atrophy. Frontotemporal dementia and semantic dementia showed bilateral hippocampal atrophy, and in semantic dementia the left hippocampus was smaller than in Alzheimer's disease. No significant hippocampal atrophy was detected in non-fluent progressive aphasia.
Conclusions:
Hippocampal atrophy is not only a characteristic of Alzheimer's disease but also occurs in FTLD. The three clinical subtypes of FTLD show different patterns of hippocampal atrophy.
Insights
Hippocampal atrophy, a sign of Alzheimer's disease, also appears in frontotemporal lobar degeneration (FTLD). Different FTLD subtypes exhibit distinct patterns of this brain change.
Area of Science:
- Neuroimaging
- Neurology
- Dementia Research
Background:
- Hippocampal atrophy on MRI is an early marker for Alzheimer's disease (AD).
- This atrophy can also be present in other neurodegenerative conditions like frontotemporal lobar degeneration (FTLD).
Purpose of the Study:
- To compare hippocampal atrophy in FTLD subtypes and Alzheimer's disease using MRI volumetry and visual rating scales.
- To investigate the specific patterns of hippocampal atrophy across different FTLD clinical presentations.
Main Methods:
- Included 42 FTLD patients (3 subtypes), 103 Alzheimer's disease patients, and 73 controls.
- Assessed hippocampal atrophy using MRI volumetry and the medial temporal lobe atrophy (MTA) visual rating scale.
Main Results:
- Both FTLD and Alzheimer's disease showed significant hippocampal atrophy compared to controls.
- Frontotemporal dementia and semantic dementia subtypes displayed bilateral hippocampal atrophy; semantic dementia showed a smaller left hippocampus than AD.
- Progressive non-fluent aphasia did not exhibit significant hippocampal atrophy.
Conclusions:
- Hippocampal atrophy is a characteristic of both Alzheimer's disease and frontotemporal lobar degeneration.
- The three clinical subtypes of FTLD demonstrate varying patterns of hippocampal atrophy.
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