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Abstract
To compare and dissociate the neural correlates of Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD), we combine and synthesize here recent comprehensive meta-analyses. Systematic and quantitative meta-analyses were conducted according to the QUOROM statement by calculating anatomical likelihood estimates (ALE). AD (n = 578) and the three subtypes of FTLD, frontotemporal dementia, semantic dementia (SD), and progressive non-fluent aphasia (n = 229), were compared in conjunction analyses, separately for atrophy and reductions in glucose metabolism. Atrophy coincided in the amygdala and hippocampal head in AD and the FTLD subtype SD. The other brain regions did not show any overlap between AD and FTLD subtypes for both atrophy and changes in glucose metabolism. For AD alone (n = 826), another conjunction analysis revealed a regional dissociation between atrophy and hypoperfusion/hypometabolism, whereby hypoperfusion and hypometabolism coincided in the angular/supramarginal gyrus and inferior precuneus/posterior cingulate gyrus. Our data together with other imaging studies suggest a specific dissociation of AD and FTLD if, beside atrophy, additional imaging markers in AD such as abnormally low parietal glucose utilization and perfusion are taken into account. Results support the incorporation of standardized imaging inclusion criteria into future diagnostic systems, which is crucial for early individual diagnosis and treatment in the future.
Highlights
Neurodegenerative disorders are a major public health problem (Dubois et al, 2007; Kipps et al, 2009)
Note that we did not include subjects with amnestic mild cognitive impairment (MCI), because it is considered as a prodromal stage of Alzheimer’s disease (AD) and the frontotemporal lobar degeneration (FTLD) subtypes may be associated with other non-amnestic prodromal stages such as dysexecutive MCI or mild behavioral (FTD) or language www.frontiersin.org
An ANOVA including dementia subtype (AD vs. Frontotemporal dementia (FTD) vs. Progressive non-fluent aphasia (PNFA) vs. semantic dementia (SD)) as a between subjects factor and method (MRI vs. fluorodeoxyglucosepositron emission tomography (FDG-PET) vs. perfusion) as an additional factor revealed no influences of both factors on severity of dementia as measured by the mini-mental
Summary
Neurodegenerative disorders are a major public health problem (Dubois et al, 2007; Kipps et al, 2009). We have identified the prototypical neural correlates of two frequent dementia disorders, Alzheimer’s disease (AD), and frontotemporal lobar degeneration (FTLD), in comprehensive systematic and quantitative meta-analyses conducted according to the QUOROM statement (Schroeter et al, 2007, 2009). These meta-analyses involved 1618 patients and 1448 healthy control subjects and applied the anatomical likelihood estimate (ALE) method, which is regarded as the most sophisticated and best-validated of coordinate-based voxelwise meta-analyses (Fox et al, 2005; Glahn et al, 2008; Laird et al, 2009). The ALE map represents the prototypical neural correlates of a specific dementia syndrome
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