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MRI Signatures of Brain Macrostructural Atrophy and Microstructural Degradation in Frontotemporal Lobar Degeneration Subtypes

Article type: Research Article

Authors: Zhang, Yua; b; * | Tartaglia, Maria Carmelac; d | Schuff, Norberta; b | Chiang, Gloria C.a; b | Ching, Christophera; b | Rosen, Howard J.c | Gorno-Tempini, Maria Luisac | Miller, Bruce L.c | Weiner, Michael W.a; b

Affiliations: [a] Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA | [b] Department of Radiology, University of California, San Francisco, CA, USA | [c] Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA | [d] University Health Network and Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, ON, Canada

Correspondence: [*] Correspondence to: Yu Zhang, MD, Center for Imaging of Neurodegenerative Diseases, VA Medical Center, 4150, Clement Street, San Francisco, CA 94121, USA. Tel.: +1 415 2214810; Ext: 2158; Fax: +1 415 6682864; E-mail: [email protected].

Keywords: Behavioral variant frontotemporal dementia, diffusion tensor imaging, frontotemporal lobar degeneration, multimodality MRI, progressive nonfluent aphasia, semantic dementia

DOI: 10.3233/JAD-2012-121156

Journal: Journal of Alzheimer's Disease, vol. 33, no. 2, pp. 431-444, 2013

Accepted 4 August 2012
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Published: 17 December 2012
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Supplementary Materials:

Supplementary Materials.

Abstract

Brain magnetic resonance imaging (MRI) studies have demonstrated regional patterns of brain macrostructural atrophy and white matter microstructural alterations separately in the three major subtypes of frontotemporal lobar degeneration (FTLD), which includes behavioral variant frontotemporal dementia (bvFTD), semantic dementia (SD), and progressive nonfluent aphasia (PNFA). This study was to investigate to what extent the pattern of white matter microstructural alterations in FTLD subtypes mirrors the pattern of brain atrophy, and to compare the ability of various diffusion tensor imaging (DTI) indices in characterizing FTLD patients, as well as to determine whether DTI measures provide greater classification power for FTLD than measuring brain atrophy. Twenty-five patients with FTLD (13 with bvFTD, 6 with SD, and 6 with PNFA) and 19 healthy age-matched control subjects underwent both structural MRI and DTI scans. Measurements of regional brain atrophy were based on T1-weighted MRI data and voxel-based morphometry. Measurements of regional white matter degradation were based on voxelwise as well as regions-of-interest tests of DTI variations, expressed as fractional anisotropy, axial diffusivity, and radial diffusivity. Compared to controls, bvFTD, SD, and PNFA patients each exhibited characteristic regional patterns of brain atrophy and white matter damage. DTI overall provided significantly greater accuracy for FTLD classification than brain atrophy. Moreover, radial diffusivity was more sensitive in assessing white matter damage in FTLD than other DTI indices. The findings suggest that DTI in general and radial diffusivity in particular are more powerful measures for the classification of FTLD patients from controls than brain atrophy.

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