RT Journal Article
SR Electronic
T1 Focal atrophy on MRI and neuropathologic classification of dementia with Lewy bodies
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 553
OP 560
DO 10.1212/WNL.0b013e31826357a5
VO 79
IS 6
A1 Kejal Kantarci
A1 Tanis J. Ferman
A1 Bradley F. Boeve
A1 Stephen D. Weigand
A1 Scott Przybelski
A1 Prashanthi Vemuri
A1 Melissa M. Murray
A1 Matthew L. Senjem
A1 Glenn E. Smith
A1 David S. Knopman
A1 Ronald C. Petersen
A1 Clifford R. Jack, Jr.
A1 Joseph E. Parisi
A1 Dennis W. Dickson
YR 2012
UL http://n.neurology.org/content/79/6/553.abstract
AB 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. 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.