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. 2007 Jul;28(7):1051-61.
doi: 10.1016/j.neurobiolaging.2006.05.026. Epub 2006 Jun 23.

Imaging correlates of posterior cortical atrophy

Jennifer L Whitwell  1 , Clifford R Jack Jr, Kejal Kantarci, Stephen D Weigand, Bradley F Boeve, David S Knopman, Daniel A Drubach, David F Tang-Wai, Ronald C Petersen, Keith A Josephs
Affiliations

Imaging correlates of posterior cortical atrophy

Jennifer L Whitwell et al. Neurobiol Aging. 2007 Jul.

Abstract

The aim of this study was to compare patterns of cerebral atrophy on MRI, and neurochemistry on magnetic resonance spectroscopy (MRS), in patients with posterior cortical atrophy (PCA) and typical Alzheimer's disease (AD). Voxel-based morphometry was used to assess grey matter atrophy in 38 patients with PCA, 38 patients with typical AD, and 38 controls. Clinical data was assessed in all PCA patients. Single voxel (1)H MRS located in the posterior cingulate was analyzed in a subset of patients with PCA, typical AD, and control subjects. PCA showed a pattern of atrophy affecting occipital, parietal and posterior temporal lobes, compared to controls. The pattern was bilateral, but more severe on the right. Patients with PCA showed greater atrophy in the right visual association cortex than patients with typical AD, whereas those with AD showed greater atrophy in the left hippocampus than those with PCA. (1)H MRS suggested loss of neuronal integrity and glial activation in subjects with PCA and typical AD. The differing patterns of atrophy on MRI suggest that PCA should be considered a distinct entity from typical AD.

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Figures

Figure 1
Figure 1
Patterns of grey matter atrophy in the PCA group (A and C) and AD group (B and D), compared to healthy controls (corrected for multiple comparisons, p<0.05). Results have been overlaid both on a 3D surface render (A and B) and on representative coronal MRI slices (C and D) from a healthy control. Warmer colors indicate statistically greater differences between groups.
Figure 2
Figure 2
Regions showing significantly greater grey matter atrophy in the PCA group than the AD group (uncorrected for multiple comparisons, p<0.001), overlaid on an MRI from a healthy control
Figure 3
Figure 3
Regions showing significantly greater grey matter atrophy in the AD group than the PCA group (uncorrected for multiple comparisons, p<0.001), overlaid on an MRI from a healthy control
Figure 4
Figure 4
Boxplots of the distribution of 1H MRS metabolite ratios from a single voxel in the posterior cingulate and precunei by group. The boxes show the median and inter-quartile range with the means indicated by a triangle. The whiskers extend to the furthest data points that are not outliers (shown as separate points). NAA= N-acetyl aspartate; Cr = creatine; Cho = choline; mI = myo-inositol
See this image and copyright information in PMC

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