Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Aug 7;79(6):553-60.
doi: 10.1212/WNL.0b013e31826357a5. Epub 2012 Jul 25.

Focal atrophy on MRI and neuropathologic classification of dementia with Lewy bodies

Kejal Kantarci  1 , Tanis J Ferman, Bradley F Boeve, Stephen D Weigand, Scott Przybelski, Prashanthi Vemuri, Melissa E Murray, Matthew L Senjem, Glenn E Smith, David S Knopman, Ronald C Petersen, Clifford R Jack Jr, Joseph E Parisi, Dennis W Dickson
Affiliations

Focal atrophy on MRI and neuropathologic classification of dementia with Lewy bodies

Kejal Kantarci et al. Neurology. .

Erratum in

  • Neurology. 2012 Sep 4;79(10):1072. Murray, Melissa M [corrected to Murray, Melissa E]

Abstract

Objective: To determine the association between the focal atrophy measures on antemortem MRI and postmortem neuropathologic classification of dementia with Lewy bodies (DLB) using the Third Report of the DLB Consortium criteria.

Methods: We retrospectively identified 56 subjects who underwent antemortem MRI and had Lewy body (LB) pathology at autopsy. Subjects were pathologically classified as high (n = 25), intermediate (n = 22), and low likelihood DLB (n = 9) according to the Third Report of the DLB Consortium criteria. We included 2 additional pathologic comparison groups without LBs: one with low likelihood Alzheimer disease (AD) (control; n = 27) and one with high likelihood AD (n = 33). The associations between MRI-based volumetric measurements and the pathologic classification of DLB were tested with analysis of covariance by adjusting for age, sex, and MRI-to-death interval.

Results: Antemortem hippocampal and amygdalar volumes increased from low to intermediate to high likelihood DLB (p < 0.001, trend test). Smaller hippocampal and amygdalar volumes were associated with higher Braak neurofibrillary tangle stage (p < 0.001). Antemortem dorsal mesopontine gray matter (GM) atrophy was found in those with high likelihood DLB compared with normal control subjects (p = 0.004) and those with AD (p = 0.01). Dorsal mesopontine GM volume decreased from low to intermediate to high likelihood DLB (p = 0.01, trend test).

Conclusion: Antemortem hippocampal and amygdalar volumes increase and dorsal mesopontine GM volumes decrease in patients with low to high likelihood DLB according to the Third Report of the DLB Consortium criteria. Patients with high likelihood DLB typically have normal hippocampal volumes but have atrophy in the dorsal mesopontine GM nuclei.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Box and whiskers plots of hippocampal volumes as a percentage of total intracranial volume by pathologic classification
Boxes indicate the lower quartile, median, and upper quartile of the distributions with whiskers extending to the furthest data point within 1.5 times the interquartile range of the box. Points beyond the whiskers are individually identified. Pairwise p values shown are based on an analysis of covariance model among all subjects, whereas the p value for trend is based on subjects with dementia with Lewy bodies (DLB) only.
Figure 2
Figure 2. Box and whiskers plots of amygdalar volumes as a percentage of total intracranial volume by pathologic classification
Boxes indicate the lower quartile, median, and upper quartile of the distributions with whiskers extending to the furthest data point within 1.5 times the interquartile range of the box. Points beyond the whiskers are individually identified. Pairwise p values shown are based on an analysis of covariance model among all subjects, whereas the p value for trend is based on subjects with dementia with Lewy bodies (DLB) only.
Figure 3
Figure 3. Box and whiskers plots of dorsal mesopontine gray matter volumes as a percentage of total intracranial volume by pathologic classification
Boxes indicate the lower quartile, median, and upper quartile of the distributions with whiskers extending to the furthest data point within 1.5 times the interquartile range of the box. Points beyond the whiskers are individually identified. Pairwise p values shown are based on an analysis of covariance model among all subjects, whereas the p value for trend is based on subjects with dementia with Lewy bodies (DLB) only.
See this image and copyright information in PMC

References

    1. Schneider JA, Arvanitakis Z, Bang W, Bennett DA. Mixed brain pathologies account for most dementia cases in community-dwelling older persons. Neurology 2007;69:2197–2204 - PubMed
    1. Hansen L, Salmon D, Galasko D, et al. The Lewy body variant of Alzheimer's disease: a clinical and pathologic entity. Neurology 1990;40:1–8 - PubMed
    1. Gomez-Tortosa E, Newell K, Irizarry MC, Albert M, Growdon JH, Hyman BT. Clinical and quantitative pathologic correlates of dementia with Lewy bodies. Neurology 1999;53:1284–1291 - PubMed
    1. Galasko D, Hansen LA, Katzman R, et al. Clinical-neuropathological correlations in Alzheimer's disease and related dementias. Arch Neurol 1994;51:888–895 - PubMed
    1. Fujishiro H, Iseki E, Higashi S, et al. Distribution of cerebral amyloid deposition and its relevance to clinical phenotype in Lewy body dementia. Neurosci Lett 2010;486:19–23 - PubMed

Publication types