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Basal forebrain atrophy in frontotemporal dementia.

Rhian S Convery1, Mollie R Neason1, David M Cash2

  • 1Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.

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|March 7, 2020
PubMed
Summary

Frontotemporal dementia (FTD) significantly reduces basal forebrain volume, especially in semantic variant primary progressive aphasia (svPPA) and behavioral variant FTD (bvFTD). Tauopathies, particularly MAPT mutations, showed the most severe volume loss.

Keywords:
Frontotemporal dementiaMRI, Basal forebrainVolumetry

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Area of Science:

  • Neuroscience
  • Neurology
  • Radiology

Background:

  • The basal forebrain is crucial for learning, attention, and memory.
  • Frontotemporal dementia (FTD) affects subcortical structures, but basal forebrain involvement is understudied.
  • Research is needed to understand basal forebrain changes in FTD.

Purpose of the Study:

  • To investigate differences in basal forebrain volumes in FTD.
  • To compare volumes across clinical, genetic, and pathological FTD diagnoses.
  • To identify specific FTD subtypes with significant basal forebrain atrophy.

Main Methods:

  • 356 FTD patients and 83 controls underwent T1-weighted MRI.
  • Basal forebrain volumes were calculated using the Geodesic Information Flow (GIF) method.
  • Volumes were compared between clinical (bvFTD, svPPA, etc.), genetic (MAPT, GRN, C9orf72), and pathological (tau, FUS, TDP-43) groups.

Main Results:

  • All FTD clinical subtypes showed smaller basal forebrain volumes than controls (p ≤ 0.010).
  • svPPA (10%) and bvFTD (9%) had the most significant volume reductions.
  • MAPT mutations (18%) and specific tauopathies (FTDP-17, Pick's disease) and TDP-43 type C also showed reduced volumes.

Conclusions:

  • Basal forebrain involvement is common in FTD, with varying degrees of volume reduction across diagnoses.
  • Tauopathies, especially MAPT mutations, exhibited the most pronounced volume loss.
  • Atrophy in basal forebrain suggests vulnerability to diverse FTD-associated proteinopathies, including TDP-43 type C.