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Medial temporal and whole-brain atrophy in dementia with Lewy bodies: a volumetric MRI study
M Hashimoto1, H Kitagaki, T Imamura
1Department of Clinical Neurosciences, Hyogo Institute for Aging Brain and Cognitive Disorders, Himeji, Japan.
Objective:
Dementia with Lewy bodies (DLB) is emerging as a common cause of degenerative dementia. A recent pathologic study has indicated that the medial temporal lobe in patients with DLB was less atrophic than that in patients with AD. The purpose of this study was to examine whether medial temporal MRI volumetry was useful to differentiate DLB from AD clinically.
Methods:
We compared the volumes of the hippocampal formation, amygdaloid complex, and whole brain in 27 patients with probable DLB (based on the criteria of the Consortium on DLB International Workshop), 27 patients with probable AD (based on criteria of the National Institute of Neurological Disease and Stroke/Alzheimer's Disease and Related Disorders Association), and 27 normal elderly subjects using an MRI-based volumetric technique. The three groups were matched for age and sex. Severity of cognitive disturbances represented by their Mini-Mental State Examination score was comparable between the DLB and AD groups.
Results:
Hippocampal volume (normalized to intracranial volume) in the DLB group was significantly larger than that in the AD group, but significantly smaller than that in the normal control group. There were no significant differences in the amygdala and whole-brain volume between the DLB group and the AD group, but the atrophies of the amygdala and whole brain were more severe in the DLB group than those in the control group.
Conclusions:
These findings indicate the usefulness of MRI hippocampal volumetry in clinically discriminating patients with DLB from patients with AD.
Insights
MRI hippocampal volumetry can help differentiate dementia with Lewy bodies (DLB) from Alzheimer's disease (AD). Patients with DLB showed larger hippocampal volumes than those with AD, suggesting this imaging technique aids clinical diagnosis.
Area of Science:
- Neurology
- Neuroimaging
- Dementia Research
Background:
- Dementia with Lewy bodies (DLB) is a common degenerative dementia.
- Pathological studies suggest less medial temporal lobe atrophy in DLB compared to Alzheimer's disease (AD).
- Clinical differentiation between DLB and AD remains a challenge.
Purpose of the Study:
- To investigate the utility of medial temporal MRI volumetry for distinguishing DLB from AD.
- To assess if hippocampal, amygdala, and whole-brain volumes differ between DLB and AD patients.
Main Methods:
- Compared MRI-based volumes of the hippocampal formation, amygdaloid complex, and whole brain.
- Studied 27 probable DLB patients, 27 probable AD patients, and 27 normal elderly controls.
- Groups were matched for age and sex; cognitive severity was comparable between DLB and AD groups.
Main Results:
- Hippocampal volume was significantly larger in DLB than AD, but smaller than in controls.
- No significant differences in amygdala or whole-brain volume between DLB and AD.
- Amygdala and whole-brain atrophy was more severe in DLB than controls.
Conclusions:
- MRI hippocampal volumetry is a useful tool for clinically differentiating DLB from AD.
- Differential patterns of medial temporal lobe atrophy can aid in diagnosing dementia subtypes.