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. 2016 Jul 20:8:31.
doi: 10.1186/s13195-016-0198-6.

Grey matter atrophy in prodromal stage of dementia with Lewy bodies and Alzheimer's disease

Frederic Blanc  1   2   3 , Sean J Colloby  4 , Benjamin Cretin  5   6 , Paulo Loureiro de Sousa  6 , Catherine Demuynck  5 , John T O'Brien  4   7 , Catherine Martin-Hunyadi  5 , Ian McKeith  4 , Nathalie Philippi  5   6 , John-Paul Taylor  4
Affiliations

Grey matter atrophy in prodromal stage of dementia with Lewy bodies and Alzheimer's disease

Frederic Blanc et al. Alzheimers Res Ther. .

Abstract

Background: Little is known about the patterns of brain atrophy in prodromal dementia with Lewy bodies (pro-DLB).

Methods: In this study, we used SPM8 with diffeomorphic anatomical registration through exponentiated lie algebra to measure grey matter (GM) volume and investigate patterns of GM atrophy in pro-DLB (n = 28) and prodromal Alzheimer's disease (pro-AD) (n = 27) and compared and contrasted them with those in elderly control subjects (n = 33) (P ≤ 0.05 corrected for family-wise error).

Results: Patients with pro-DLB showed diminished GM volumes of bilateral insulae and right anterior cingulate cortex compared with control subjects. Comparison of GM volume between patients with pro-AD and control subjects showed a more extensive pattern, with volume reductions in temporal (hippocampi and superior and middle gyri), parietal and frontal structures in the former. Direct comparison of prodromal groups suggested that more atrophy was evident in the parietal lobes of patients with pro-AD than patients with pro-DLB. In patients with pro-DLB, we found that visual hallucinations were associated with relative atrophy of the left cuneus.

Conclusions: Atrophy in pro-DLB involves the insulae and anterior cingulate cortex, regions rich in von Economo neurons, which we speculate may contribute to the early clinical phenotype of pro-DLB.

Keywords: Alzheimer’s dementia; Alzheimer’s disease; Dementia with Lewy bodies; Insula; Lewy body disease; MRI; Mild cognitive impairment; Prodromal Alzheimer’s disease; Prodromal dementia with Lewy bodies.

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Figures

Fig. 1
Fig. 1
Flowchart of the present study on grey matter atrophy in prodromal stages of dementia with Lewy bodies and Alzheimer’s disease. Prodromal DLB is defined as patients with the McKeith et al. criteria of DLB with cognitive impairment but without dementia. Psychiatric pathologies included two patients with depression, one with bipolar disorder and one with histrionic personality disorder. In addition, among patients with MCI, one had cognitive impairment due to severe sleep apnoea, one had vitamin B12 encephalopathy and one had mitochondriopathy. AD Alzheimer’s disease, DLB dementia with Lewy bodies, MCI mild cognitive impairment
Fig. 2
Fig. 2
Significant grey matter (GM) loss in the prodromal dementia with Lewy bodies (pro-DLB) (a) and prodromal Alzheimer’s disease (pro-AD) (b) groups relative to healthy older control subjects. GM atrophy in pro-AD compared with pro-DLB (c). Results (P FWE ≤ 0.05) are superimposed upon a magnetic resonance imaging T1-weighted brain template image in axial views. L left, R right, FWE family-wise error
Fig. 3
Fig. 3
Significant grey matter loss in prodromal dementia with Lewy bodies (pro-DLB) visual hallucinators compared with pro-DLB non-hallucinators. Results (P uncorrected ≤ 0.005) superimposed on a magnetic resonance imaging T1-weighted brain template scan in axial (on the left) and sagittal (on the right, b). L left, R right
See this image and copyright information in PMC

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