Document Detail

Atrophy patterns in histologic vs clinical groupings of frontotemporal lobar degeneration.
MedLine Citation:
PMID:  19433738     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Predictable patterns of atrophy are associated with the clinical subtypes of frontotemporal dementia (FTD): behavioral variant (bvFTD), semantic dementia (SEMD), and progressive nonfluent aphasia (PNFA). Some studies of pathologic subtypes have also suggested specific atrophy patterns; however, results are inconsistent. Our aim was to test the hypothesis that clinical, but not pathologic, classification (FTD with ubiquitin inclusions [FTD-U] and FTD with tau inclusions [FTD-T]) is associated with predictable patterns of regional atrophy.
METHODS: Magnetic resonance scans of nine FTD-U and six FTD-T patients (histologically confirmed) were compared with 25 controls using voxel-based morphometry (VBM). Analyses were conducted with the patient group classified according to histologic or clinical variant. Additionally, three Alzheimer pathology patients who had the syndrome of SEMD in life (FTD-A) were analyzed.
RESULTS: The VBM studies in clinical variants confirmed established patterns of atrophy (SEMD, rostral temporal; bvFTD, mesial frontal; PNFA, left insula). FTD-U and FTD-T VBM results were very similar, showing severe atrophy in the temporal poles, mesial frontal lobe, and insulae. A conjunction analysis confirmed this similarity. Subgroup analysis found that SEMD associated with either FTD-T or FTD-U was associated with similar rostral temporal atrophy; however, FTD-A had a qualitatively different pattern of left hippocampal atrophy.
CONCLUSIONS: While there is predictable atrophy for clinical variants of frontotemporal dementia (FTD), histologic FTD variants show no noticeable differences. Reports of specific atrophy profiles are likely the result of idiosyncrasies in small groups. Semantic dementia associated with Alzheimer pathology, however, presented a distinct atrophy pattern.
J M S Pereira; G B Williams; J Acosta-Cabronero; G Pengas; M G Spillantini; J H Xuereb; J R Hodges; P J Nestor
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurology     Volume:  72     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-12     Completed Date:  2009-06-30     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1653-60     Citation Subset:  AIM; IM    
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MeSH Terms
Aphasia, Primary Progressive / pathology,  physiopathology
Atrophy / classification,  etiology,  pathology*
Brain Mapping / methods
Cerebral Cortex / pathology*,  physiopathology
Dementia / classification,  pathology*,  physiopathology
Disease Progression
Frontal Lobe / pathology,  physiopathology
Functional Laterality / physiology
Hippocampus / pathology,  physiopathology
Image Processing, Computer-Assisted / methods
Inclusion Bodies / pathology
Magnetic Resonance Imaging / methods
Middle Aged
Severity of Illness Index
Temporal Lobe / pathology,  physiopathology
Grant Support
G0301152//Medical Research Council; G0600986//Medical Research Council; G108/653//Medical Research Council; G9724461//Medical Research Council; //Medical Research Council

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