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Medial temporal atrophy predicts the limbic comorbidities in lewy body disease

Keita Sakurai1, Daita Kaneda2, Satoru Morimoto3

  • 1Department of Radiology, National Center for Geriatrics and Gerontology, 7-430 Morioka-Cho, Obu, Aichi, 474-8511, Japan. ksak666@yahoo.co.jp.

Neuroradiology
|November 12, 2024
PubMed
Abstract

Insights

Magnetic resonance imaging (MRI) indices of medial temporal atrophy can help differentiate pure Lewy body disease (LBD) from mixed LBD with Alzheimer's disease neuropathological change (AD-NC) or limbic-predominant age-related TAR DNA-binding protein 43encephalopathy neuropathological change (LATE-NC). These MRI findings correlate with AD-NC severity and aid in diagnosing LBD comorbidities.

Area of Science:

  • Neurology
  • Radiology
  • Pathology

Background:

  • Lewy body disease (LBD) often co-occurs with Alzheimer's disease neuropathological change (AD-NC) and limbic-predominant age-related TAR DNA-binding protein 43encephalopathy neuropathological change (LATE-NC).
  • Medial temporal atrophy is associated with these comorbidities in LBD, but the diagnostic utility of MRI is not well-established.

Purpose of the Study:

  • To evaluate the diagnostic performance of MRI-derived medial temporal atrophy indices in distinguishing between pure LBD and mixed LBD (mLBD) with AD-NC and/or LATE-NC.

Main Methods:

  • Included 24 pathologically confirmed mLBD and 16 pure LBD patients.
  • Assessed medial temporal atrophy using entorhinal cortex atrophy (ERICA) scores and cross-sectional areas of entorhinal cortices/parahippocampal gyri (ABEP).

Main Results:

  • ABEP and ERICA scores showed significant diagnostic performance in differentiating mLBD from pure LBD (AUC 0.87 and 0.80, respectively).
  • ABEP demonstrated high diagnostic performance (AUC 0.94) in distinguishing pure LBD from mLBD with both AD-NC and LATE-NC.
  • MRI indices, particularly ABEP, correlated with AD-NC severity and showed a trend with LATE-NC.

Conclusions:

  • Medial temporal atrophy on MRI is a valuable tool for diagnosing comorbidities in pathologically confirmed LBD.
  • MRI-derived indices effectively differentiate LBD subtypes based on the presence of AD-NC and LATE-NC.
Keywords:
Alzheimer’s diseaseComorbidityLewy body diseaseLimbic-predominant age-related TDP-43 encephalopathyMagnetic resonance imagingMedial temporal atrophyNeurofibrillary tangle

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