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MRI data-driven clustering reveals different subtypes of Dementia with Lewy bodies
Anna Inguanzo1,2,3, Konstantinos Poulakis1, Rosaleena Mohanty1
1Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden.
Abstract:
Dementia with Lewy bodies (DLB) is a neurodegenerative disorder with a wide heterogeneity of symptoms, which suggests the existence of different subtypes. We used data-driven analysis of magnetic resonance imaging (MRI) data to investigate DLB subtypes. We included 165 DLB from the Mayo Clinic and 3 centers from the European DLB consortium and performed a hierarchical cluster analysis to identify subtypes based on gray matter (GM) volumes. To characterize the subtypes, we used demographic and clinical data, as well as β-amyloid, tau, and cerebrovascular biomarkers at baseline, and cognitive decline over three years. We identified 3 subtypes: an older subtype with reduced cortical GM volumes, worse cognition, and faster cognitive decline (n = 49, 30%); a subtype with low GM volumes in fronto-occipital regions (n = 76, 46%); and a subtype of younger patients with the highest cortical GM volumes, proportionally lower GM volumes in basal ganglia and the highest frequency of cognitive fluctuations (n = 40, 24%). This study shows the existence of MRI subtypes in DLB, which may have implications for clinical workout, research, and therapeutic decisions.
Insights
Researchers identified three distinct subtypes of Dementia with Lewy bodies (DLB) using MRI scans. These subtypes differ in age, brain structure, and cognitive decline, impacting future research and treatment strategies.
Area of Science:
- Neuroscience
- Radiology
- Gerontology
Background:
- Dementia with Lewy bodies (DLB) presents with heterogeneous symptoms, suggesting potential underlying subtypes.
- Understanding these subtypes is crucial for targeted research and clinical management.
Purpose of the Study:
- To investigate potential subtypes of Dementia with Lewy bodies (DLB) using magnetic resonance imaging (MRI) data.
- To characterize identified DLB subtypes using clinical, demographic, and biomarker data.
Main Methods:
- Hierarchical cluster analysis of gray matter (GM) volumes from MRI scans of 165 DLB patients.
- Characterization of subtypes using baseline demographic, clinical, and biomarker data (amyloid, tau, cerebrovascular).
- Assessment of cognitive decline over a three-year period.
Main Results:
- Three distinct DLB subtypes were identified based on GM volumes.
- Subtype 1 (30%): Older patients, reduced cortical GM, worse cognition, faster decline.
- Subtype 2 (46%): Low fronto-occipital GM volumes.
- Subtype 3 (24%): Younger patients, highest cortical GM, lower basal ganglia GM, frequent cognitive fluctuations.
Conclusions:
- The study confirms the existence of distinct MRI-defined subtypes in DLB.
- These findings may inform clinical diagnosis, research directions, and therapeutic interventions for DLB.
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