Longitudinal grey and white matter changes in frontotemporal dementia and Alzheimer's disease

Lars Frings, Belinda Yew, Emma Flanagan, Bonnie Y K Lam, Michael Hüll, Hans-Jürgen Huppertz, John R Hodges, Michael Hornberger, Lars Frings, Belinda Yew, Emma Flanagan, Bonnie Y K Lam, Michael Hüll, Hans-Jürgen Huppertz, John R Hodges, Michael Hornberger

Abstract

Behavioural variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) dementia are characterised by progressive brain atrophy. Longitudinal MRI volumetry may help to characterise ongoing structural degeneration and support the differential diagnosis of dementia subtypes. Automated, observer-independent atlas-based MRI volumetry was applied to analyse 102 MRI data sets from 15 bvFTD, 14 AD, and 10 healthy elderly control participants with consecutive scans over at least 12 months. Anatomically defined targets were chosen a priori as brain structures of interest. Groups were compared regarding volumes at clinic presentation and annual change rates. Baseline volumes, especially of grey matter compartments, were significantly reduced in bvFTD and AD patients. Grey matter volumes of the caudate and the gyrus rectus were significantly smaller in bvFTD than AD. The bvFTD group could be separated from AD on the basis of caudate volume with high accuracy (79% cases correct). Annual volume decline was markedly larger in bvFTD and AD than controls, predominantly in white matter of temporal structures. Decline in grey matter volume of the lateral orbitofrontal gyrus separated bvFTD from AD and controls. Automated longitudinal MRI volumetry discriminates bvFTD from AD. In particular, greater reduction of orbitofrontal grey matter and temporal white matter structures after 12 months is indicative of bvFTD.

Conflict of interest statement

Competing Interests: M Hüll: Personal Compensation: Honoraria for lectures from Pfizer and Merz; Advisory board for Hoffmann-LaRoche; Publishing royalties for Die Antidepressionsstrategie im Alter. Kreuz Verlag Stuttgart, 2011; Psychische Erkrankungen (Hrsg.: Berger M), München Elsevier-Verlag, 2012; Funding support: Grants from the German Federal Ministry of Education and Research (BMBF), German Research Community (DFG), Schwabe GmbH, PI in clinicals trials from Pfizer, AbbVie. HJ Huppert: Funding support: Swiss Epilepsy Foundation. JR Hodges: Editorial Boards: Nature Reviews Neurology, Aphasiology, Cognitive Neuropsychiatry, Cognitive Neuropsychology. Personal Compensation: Publishing royalties for Cognitive Assessment for Clinicians (Oxford University Press, 2007), Frontotemporal Dementia Syndromes (Cambridge University Press, 2007); Funding support: The Australian Research Council and the National Health and Medical Research Council of Australia. M Hornberger: Editorial Boards: Journal of Alzheimer's Disease, Dementia and Geriatric Cognitive Disorders; Funding Support: The Australian Research Council. L Frings, B Yew, E Flanagan, BYK Lam have declared that no competing interests exist. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1. Volumes at clinic presentation (ml;…
Figure 1. Volumes at clinic presentation (ml; Mean +/– 1 S.D.) of caudate and gyrus rectus grey matter.
Brackets indicate significant group differences. Red dots indicate data from Freiburg. CON  =  control participants.
Figure 2. Annualised volume change (%; mean…
Figure 2. Annualised volume change (%; mean +/– 1 S.D.) of LOFG grey matter.
Brackets indicate significant group differences. Red dots indicate data from Freiburg. CON  =  control participants.

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