The MRI pattern of frontal and temporal brain atrophy in fronto-temporal dementia

• Published in: Neurobiology of aging 2003-01, Vol.24 (1), p.95-103
• Main Authors: Boccardi, Marina, Laakso, Mikko P, Bresciani, Lorena, Galluzzi, Samantha, Geroldi, Cristina, Beltramello, Alberto, Soininen, Hilkka, Frisoni, Giovanni B
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - pathology; Alzheimer Disease - physiopathology; Analysis of Variance; Atrophy - etiology; Biological and medical sciences; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia - pathology; Differential diagnosis; Female; Frontal Lobe - pathology; Frontal lobes; Fronto-temporal dementia; Hippocampus; Hippocampus - pathology; Hippocampus - physiopathology; Humans; Image Processing, Computer-Assisted; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical sciences; Middle Aged; Neurology; Psychiatric Status Rating Scales; Temporal lobe; Temporal Lobe - pathology
• ISSN: 0197-4580; 1558-1497
• DOI: 10.1016/S0197-4580(02)00045-3

Objective: To compare patterns of brain atrophy in fronto-temporal dementia (FTD) and Alzheimer’s disease (AD) since atrophy in individual areas may not be sufficiently specific as diagnostic marker. Methods: Frontal, temporal and hippocampal atrophy was measured from MRI of 10 FTD patients, 27 AD, and 27 controls. Corrected atrophy and asymmetry were computed (W-scores). Results: FTD had mild atrophy in the hippocampus (average W-score=−1.3), severe in the frontal (W-score=−2.4) and very severe in the temporal lobes (W-score=−2.9). AD had moderate atrophy in the hippocampus and temporal lobes (W-score=−1.8 and −1.9, respectively), and very mild frontal atrophy (W-score=−0.9). Atrophy was more asymmetrical in FTD (left more atrophic) than in AD patients, particularly in the temporal lobes. A discriminant function including the asymmetry values of frontal and temporal regions could separate FTD from AD with 90% sensitivity and 93% specificity. Conclusions: FTD is characterized by a specific pattern of atrophy, more useful than atrophy of single regions in the differential diagnosis.