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.
Highlights
Behavioural variant frontotemporal dementia and Alzheimer’s disease (AD) are the two most prevalent early-onset dementias [1]
The revised diagnostic criteria for Behavioural variant frontotemporal dementia (bvFTD) [6] incorporate neuroimaging evidence of frontal and/or temporal brain atrophy changes at presentation
BvFTD show characteristic frontal and anterior temporal lobe atrophy [9,10,11], with the hippocampus being affected to a similar degree as in AD [12,13,14]
Summary
Behavioural variant frontotemporal dementia (bvFTD) and Alzheimer’s disease (AD) are the two most prevalent early-onset dementias [1]. Diagnostic criteria for both have been proposed [2,3] but clinical diagnosis remains challenging [4,5]. The revised diagnostic criteria for bvFTD [6] incorporate neuroimaging evidence of frontal and/or temporal brain atrophy changes at presentation. BvFTD show characteristic frontal and anterior temporal lobe atrophy [9,10,11], with the hippocampus being affected to a similar degree as in AD [12,13,14]. BvFTD and AD show differential white matter changes involving frontal and parietal structures, respectively, while both groups appear to show similar levels of temporal lobe white matter change [12,13,14]
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