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Updated: Jun 15, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Caudate atrophy on MRI is a characteristic feature of FTLD-FUS
K A Josephs1, J L Whitwell, J E Parisi
1Department of Neurology (Behavioral Neurology), Mayo Clinic, Rochester, MN 55905, USA. josephs.keith@mayo.edu
Background And Purpose:
Frontotemporal lobar degeneration (FTLD) can be subdivided into those in which the abnormal protein is tau (FTLD-TAU), the TAR DNA binding protein 43 (FTLD-TDP) and the fused in sarcoma protein (FTLD-FUS). We have observed severe caudate atrophy at autopsy in FTLD-FUS, and hence, we aimed to determine whether caudate atrophy on MRI is a feature that can distinguish FTLD-FUS from FTLD-TDP and FTLD-TAU.
Methods:
From a cohort of 207 cases of FTLD, we identified all cases of FTLD-FUS that had a volumetric antemortem head MRI (n = 3). Caudate and frontal lobe volumes were measured in all three cases using atlas-based parcellation and SPM5 and were compared to 10 randomly selected cases of FTLD-TDP and 10 randomly selected cases of FTLD-TAU. Total grey matter volumes were also calculated for all cases.
Results:
The FTLD-FUS cases had significantly smaller caudate volumes (P = 0.02) yet similar frontal lobe grey matter volumes (P = 0.12) compared to FTLD-TDP and FTLD-TAU. Caudate volumes when corrected for total grey matter volume (P = 0.01) or frontal lobe grey matter volume (P = 0.01) were significantly smaller in FTLD-FUS than in FTLD-TDP and FTLD-TAU and showed no overlap with the other two groups.
Conclusions:
Caudate atrophy on MRI appears to be significantly greater in FTLD-FUS compared with FTLD-TDP and FTLD-TAU, suggesting that severe caudate atrophy may be a useful clinical feature to predict FTLD-FUS pathology.
Insights
Frontotemporal lobar degeneration (FTLD) with fused in sarcoma protein (FTLD-FUS) pathology shows significant caudate atrophy on MRI. This finding may help distinguish FTLD-FUS from FTLD-TDP and FTLD-TAU.
Area of Science:
- Neuroimaging
- Neuropathology
- Neurodegenerative Diseases
Background:
- Frontotemporal lobar degeneration (FTLD) is classified into subtypes based on abnormal protein aggregation: tau (FTLD-TAU), TAR DNA-binding protein 43 (FTLD-TDP), and fused in sarcoma (FTLS-FUS).
- Autopsy studies have indicated severe caudate atrophy in FTLD-FUS cases.
Observation:
- This study investigated whether magnetic resonance imaging (MRI) can detect caudate atrophy to differentiate FTLD-FUS from FTLD-TDP and FTLD-TAU.
- Volumetric MRI analysis was performed on three FTLD-FUS cases and compared with ten FTLD-TDP and ten FTLD-TAU cases.
Findings:
- FTLD-FUS cases exhibited significantly smaller caudate volumes compared to FTLD-TDP and FTLD-TAU cases (P = 0.02).
- Even after correcting for total grey matter or frontal lobe volume, caudate atrophy remained significantly greater in FTLD-FUS, with no overlap between groups (P = 0.01).
- Frontal lobe grey matter volumes were similar across all FTLD subtypes.
Implications:
- Severe caudate atrophy detected via MRI may serve as a valuable imaging biomarker for predicting FTLD-FUS pathology.
- This finding could aid in the clinical diagnosis and differentiation of FTLD subtypes, guiding further patient management.
