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Cortical morphometric subclassification of frontotemporal lobar degeneration.
O Lindberg1, P Ostberg, B B Zandbelt
1Department of Neurobiology, Care Science and Society, Section of Clinical Geriatrics, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden.
AJNR. American Journal of Neuroradiology
|April 7, 2009
Summary
Frontotemporal lobar degeneration (FTLD) subtypes show distinct brain atrophy patterns. These patterns can help differentiate between frontotemporal dementia (FTD), semantic dementia (SD), and progressive nonfluent aphasia (PNFA) for improved diagnosis.
Area of Science:
- Neurodegenerative diseases
- Neuroimaging
- Brain atrophy patterns
Background:
- Frontotemporal lobar degeneration (FTLD) is a neurodegenerative disease with three clinical subtypes: frontotemporal dementia (FTD), semantic dementia (SD), and progressive nonfluent aphasia (PNFA).
- Subtyping is based on distinct clinical symptoms.
- The relationship between clinical presentation and underlying brain atrophy patterns requires further investigation.
Purpose of the Study:
- To investigate if characteristic patterns of brain atrophy correlate with the clinical subtypes of FTLD.
- To determine if these atrophy patterns can be used to subclassify patients with FTLD.
Main Methods:
- Manual parcellation and measurement of cortical volumes in 9 regions across both hemispheres.
- Analysis of volumetric data from 27 controls, 12 FTD patients, 9 PNFA patients, and 13 SD patients.
- Application of traditional t-tests and multivariate discriminant analysis (partial least squares discriminant analysis).
Main Results:
- Brain atrophy patterns effectively discriminated between FTLD subtypes in pairwise comparisons.
- FTD vs. SD: 100% sensitivity and specificity.
- FTD vs. PNFA: 92% sensitivity, 89% specificity.
- SD vs. PNFA: 86% sensitivity, 100% specificity.
- Temporal-frontal atrophy distinguished SD; right-left atrophy distinguished FTD from PNFA.
Conclusions:
- FTLD subtypes exhibit characteristic patterns of brain atrophy.
- These distinct atrophy patterns can aid in the diagnosis and subclassification of FTLD patients.
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