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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.
GLOSSARY
- AD =
- Alzheimer disease;
- AUROC =
- area under the receiver operating characteristic curve;
- CERAD =
- Consortium to Establish a Registry for Alzheimer's Disease;
- DLB =
- dementia with Lewy bodies;
- GM =
- gray matter;
- LB =
- Lewy bodies;
- MCI =
- mild cognitive impairment;
- NFT =
- neurofibrillary tangle;
- ROI =
- region of interest.
Footnotes
Study funding: Supported by the NIH (R01-AG040042, P50-AG16574, U01-AG 06786, R01-AG11378, and C06-RR018898), the Mangurian Foundation, and the Robert H. and Clarice Smith and Abigail Van Buren Alzheimer's Disease Research Program.
- Received January 19, 2012.
- Accepted April 10, 2012.
- Copyright © 2012 by AAN Enterprises, Inc.
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