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Patterns of gray matter atrophy in dementia with Lewy bodies: a voxel-based morphometry study

Published online by Cambridge University Press:  30 November 2011

Rosie Watson*
Affiliation:
Institute for Ageing and Health, Wolfson Research Centre, Newcastle University, Newcastle upon Tyne, UK
John T. O'Brien
Affiliation:
Institute for Ageing and Health, Wolfson Research Centre, Newcastle University, Newcastle upon Tyne, UK
Robert Barber
Affiliation:
Centre for the Health of the Elderly, Newcastle General Hospital, Northumberland, Tyne & Wear NHS Trust, Newcastle upon Tyne, UK
Andrew M. Blamire
Affiliation:
Institute of Cellular Medicine & Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, UK
*
Correspondence should be addressed to: Rosie Watson, Clinical Research Associate, Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle, NE4 5PL, UK. Phone: +44 (0)191 248 1330; Fax: +44 (0)191 248 1301. Email: [email protected].

Abstract

Background: Dementia with Lewy bodies (DLB) is a common form of dementia characterized by visual hallucinations, cognitive fluctuation and parkinsonism. We aimed to compare the patterns of gray matter atrophy in DLB with those in Alzheimer's disease (AD) and normal aging, and to investigate the relationship between atrophy and cognitive measures.

Methods: We used voxel-based morphometry (VBM) to investigate gray matter (GM) loss in DLB (n = 35; mean age = 78.4; MMSE = 20.3), AD (n = 36; mean age = 78.3; MMSE = 19.5) and similar aged controls (n = 35; mean age = 76.7; MMSE = 29.1). T1 weighted MRI scans were acquired at 3 Tesla from all subjects and analyzed using VBM-DARTEL in SPM8. Cognitive function was assessed using the Cambridge Cognitive Examination (CAMCOG).

Results: We found reduced gray matter in temporal, parietal, occipital, and subcortical structures in DLB when compared to normal controls. The degree of atrophy was less than that observed in AD. There was significantly more medial temporal lobe atrophy in the AD group when compared with DLB. We did not find a correlation between total CAMCOG score and atrophy, but the CAMCOG memory subscale score correlated with temporal lobe atrophy in both the DLB and combined DLB/AD group.

Conclusions: DLB is associated with less gray matter atrophy and relative preservation of the medial temporal lobe when compared to AD. Degree of medial temporal atrophy may be a useful imaging biomarker and our results provide support for its inclusion in the revised consensus criteria for DLB.

Type
2011 IPA JUNIOR RESEARCH AWARDS – THIRD-PRIZE WINNER
Copyright
Copyright © International Psychogeriatric Association 2011

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References

Ashburner, J. (2007). A fast diffeomorphic image registration algorithm. NeuroImage, 38, 95113.CrossRefGoogle ScholarPubMed
Ashburner, J. and Friston, K. J. (2000). Voxel-based morphometry: the methods. NeuroImage, 11, 805821.CrossRefGoogle ScholarPubMed
Ashburner, J. and Friston, K. J. (2005). Unified segmentation. NeuroImage, 26, 839851.CrossRefGoogle ScholarPubMed
Barber, R., Gholkar, A., Scheltens, P., Ballard, C., McKeith, I. G. and O'Brien, J. T. (1999). Medial temporal lobe atrophy on MRI in dementia with Lewy bodies. Neurology, 52, 11531158.CrossRefGoogle ScholarPubMed
Barber, R., McKeith, I., Ballard, C. and O'Brien, J. (2002). Volumetric MRI study of the caudate nucleus in patients with dementia with Lewy bodies, Alzheimer's disease, and vascular dementia. Journal of Neurology, Neurosurgery and Psychiatry, 72, 406407.CrossRefGoogle ScholarPubMed
Beyer, M. K., Larsen, J. P. and Aarsland, D. (2007). Gray matter atrophy in Parkinson disease with dementia and dementia with Lewy bodies. Neurology, 69, 747754.CrossRefGoogle ScholarPubMed
Bucks, R. S., Ashworth, D. L., Wilcock, G. K. and Siegfried, K. (1996). Assessment of activities of daily living in dementia: development of the Bristol Activities of Daily Living Scale. Age and Ageing, 25, 113120.CrossRefGoogle ScholarPubMed
Burton, E. J. et al. (2002). Patterns of cerebral atrophy in dementia with Lewy bodies using voxel-based morphometry. NeuroImage, 17, 618630.CrossRefGoogle ScholarPubMed
Burton, E. J., McKeith, I. G., Burn, D. J., Williams, E. D. and O'Brien, J. T. (2004). Cerebral atrophy in Parkinson's disease with and without dementia: a comparison with Alzheimer's disease, dementia with Lewy bodies and controls. Brain, 127, 791800.CrossRefGoogle ScholarPubMed
Burton, E. J. et al. (2009). Medial temporal lobe atrophy on MRI differentiates Alzheimer's disease from dementia with Lewy bodies and vascular cognitive impairment: a prospective study with pathological verification of diagnosis. Brain, 132, 195203.CrossRefGoogle ScholarPubMed
Cousins, D. A., Burton, E. J., Burn, D., Gholkar, A., McKeith, I. G. and O'Brien, J. T. (2003). Atrophy of the putamen in dementia with Lewy bodies but not Alzheimer's disease: an MRI study. Neurology, 61, 11911195.CrossRefGoogle Scholar
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 23082314.CrossRefGoogle ScholarPubMed
Duda, J. (2004). Pathology and neurotransmitter abnormalities of dementia with Lewy bodies. Dementia and Geriatric Cognitive Disorders, 17, 314.CrossRefGoogle ScholarPubMed
Folstein, M., Folstein, S. and McHugh, P. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle ScholarPubMed
Friston, K. J., Holmes, A. P., Worsley, K. J., Poline, J.-P., Frith, C. D. and Frackowiak, R. S. J. (1995). Statistical parametric maps in functional imaging: a general linear approach. Human Brain Mapping, 2, 189210.CrossRefGoogle Scholar
Hanyu, H., Shimizu, S., Tanaka, Y., Hirao, K., Iwamoto, T. and Abe, K. (2007). MR features of the substantia innominata and therapeutic implications in dementias. Neurobiology of Aging, 28, 548554.CrossRefGoogle ScholarPubMed
Ishii, K. et al. (1998). Regional cerebral glucose metabolism in dementia with Lewy bodies and Alzheimer's disease. Neurology, 51, 125130.CrossRefGoogle ScholarPubMed
Jack, C. R., Petersen, R. C., Obrien, P. C. and Tangalos, E. G. (1992). MR-based hippocampal volumetry in the diagnosis of Alzheimer's disease. Neurology, 42, 183188.CrossRefGoogle ScholarPubMed
Lippa, C. F., Johnson, R. and Smith, T. W. (1998). The medial temporal lobe in dementia with Lewy bodies: a comparative study with Alzheimer's disease. Annals of Neurology, 43, 102106.CrossRefGoogle ScholarPubMed
Lobotesis, K. et al. (2001). Occipital hypoperfusion on SPECT in dementia with Lewy bodies but not AD. Neurology, 56, 643649.CrossRefGoogle Scholar
McKeith, I. et al. (1996). Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology, 47, 11131124.CrossRefGoogle Scholar
McKeith, I. et al. (2000). Prospective validation of the consensus criteria for the diagnosis of dementia with Lewy bodies. Neurology, 54, 10501058.CrossRefGoogle ScholarPubMed
McKeith, I. G. et al. (2005). Diagnosis and management of dementia with Lewy bodies: third report of the DLB consortium. Neurology, 65, 18631872.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939944.CrossRefGoogle ScholarPubMed
Middelkoop, H. A. et al. (2001). Dementia with Lewy bodies and AD are not associated with occipital lobe atrophy on MRI. Neurology, 57, 21172120.CrossRefGoogle Scholar
O'Brien, J. T. et al. (2004). Dopamine transporter loss visualized with FP-CIT SPECT in the differential diagnosis of dementia with Lewy bodies. Archives of Neurology, 61, 919925.CrossRefGoogle ScholarPubMed
Piggot, M. A. et al. (1999). Striatal dopaminergic markers in dementia with Lewy bodies, Alzheimer's and Parkinson's diseases: rostrocaudal distribution. Brain, 122, 14491468.CrossRefGoogle Scholar
Sheikh, J. and Yesavage, J. (1986). Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. In Brink, T. (ed.), Clinical Gerontolgy. A Guide to Assessment and Intervention (pp.165173). New York: The Haworth Press.Google Scholar
Takahashi, R. et al. (2010). Measurement of gray and white matter atrophy in dementia with Lewy bodies using diffeomorphic anatomic registration through exponentiated lie algebra: a comparison with conventional voxel-based morphometry. American Journal of Neuroradiology, 31, 18731878.CrossRefGoogle ScholarPubMed
Walker, M. P. et al. (2000). The Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale. British Journal of Psychiatry, 177, 252256.CrossRefGoogle ScholarPubMed
Whitwell, J. L. et al. (2007). Focal atrophy in dementia with Lewy bodies on MRI: a distinct pattern from Alzheimer's disease. Brain, 130, 708719.CrossRefGoogle ScholarPubMed
Whitwell, J. L. et al. (2008). MRI patterns of atrophy associated with progression to AD in amnestic mild cognitive impairment. Neurology, 70, 512520.CrossRefGoogle ScholarPubMed