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Dementia with Lewy bodies and Alzheimer disease: neurodegenerative patterns characterized by DTI

K Kantarci1, R Avula, M L Senjem

  • 1Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. kantarci.kejal@mayo.edu

Neurology
|June 2, 2010
PubMed
Abstract

Insights

Diffusion tensor MRI reveals distinct diffusivity patterns in dementia with Lewy bodies (DLB) and Alzheimer disease (AD). These diffusion measurements complement structural MRI, aiding in the characterization of tissue abnormalities in DLB and AD patients.

Area of Science:

  • Neuroimaging
  • Neurology
  • Radiology

Background:

  • Dementia with Lewy bodies (DLB) and Alzheimer disease (AD) are distinct neurodegenerative conditions.
  • Structural MRI is a standard tool for assessing tissue loss in these diseases.
  • Diffusion tensor MRI (DTI) offers insights into white matter integrity and microstructural changes.

Purpose of the Study:

  • To identify unique diffusivity patterns in DLB and AD using DTI.
  • To assess if DTI complements structural MRI in differentiating DLB and AD.
  • To correlate DTI findings with clinical symptoms and disease characteristics.

Main Methods:

  • Case-control study comparing DLB (n=30), AD (n=30), and cognitively normal (CN) (n=60) subjects.
  • 3T DTI with a FLAIR-based sequence for cortical diffusion measurements.
  • Quantification of mean diffusivity (MD) in gray matter and fractional anisotropy (FA) in white matter tracts.

Main Results:

  • DLB patients showed elevated amygdala MD and decreased inferior longitudinal fasciculus (ILF) FA, correlated with hallucinations and parkinsonism.
  • AD patients exhibited elevated MD in medial temporal, temporal, and parietal cortices, with decreased FA in the fornix, cingulum, and ILF.
  • Amygdala diffusivity distinguished DLB from CN; hippocampal/parahippocampal diffusivity distinguished AD from CN, complementing gray matter density.

Conclusions:

  • Increased amygdalar diffusivity in DLB may indicate microvacuolation, a hallmark of Lewy body disease.
  • DTI-derived diffusivity measurements are valuable for characterizing tissue abnormalities in AD and DLB.
  • DTI serves as a complementary tool to structural MRI for diagnosing and differentiating neurodegenerative diseases.

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