Hippocampal and entorhinal cortex atrophy in frontotemporal dementia and Alzheimer’s disease

Frisoni, Giovanni B.; Laakso, Mikko P.; Beltramello, Alberto; Geroldi, Cristina; Bianchetti, Angelo; Soininen, Hilkka; Trabucchi, Marco

doi:10.1212/wnl.52.1.91

Cited by 254 publications

(161 citation statements)

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“…However, atrophy has been shown in vascular dementia (13,14), Parkinson's disease (13,17), dementia with Lewy bodies (15,17), and frontotemporal dementia (16). Although volumetric measurement of specific medial temporal lobe structures may provide a more detailed analysis of atrophy, it is impractical because of the time required to analyze each scan.…”

Section: Discussionmentioning

confidence: 99%

“…Medial temporal lobe damage also occurs in frontotemporal dementia, but its severity is less than that in AD. Medial temporal lobe atrophy might be a deafferentation phenomenon associated with frontal and temporal damage (16). The pathologic heterogeneity in other types of dementia could be related to medial temporal lobe atrophy without altering the MT ratio.…”

Section: Discussionmentioning

confidence: 99%

“…Those with other types of dementia, identified on the basis of clinical criteria, included two patients with idiopathic Parkinson's disease, who were demented; two patients with probable dementia with Lewy bodies, according to the Consortium on DLB International Workshop criteria (30); four patients with idiopathic normal pressure hydrocephalus; three patients with probable progressive supranuclear palsy, according to the criteria of the NINDS-SPSP International Workshop (31); one patient with frontotemporal dementia, according to the criteria of the Lund and Manchester Groups (32); and one patient with Korsakoff's syndrome. The mean MMSE score of patients with vascular dementia and other dementias was 17.5 Ϯ 4.7 (range, 6-23) and 18.5 Ϯ 5.1 (range, [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25], respectively.…”

Section: Subjectsmentioning

confidence: 99%

“…Several studies with MR imaging have shown significant atrophy (2-11) and high signal intensity (12) in the medial temporal lobe, including the hippocampal formation, in patients with AD. Although volumetric measurements of medial temporal lobe structures have been proposed to aid in the diagnosis of AD, atrophic changes also occur in other dementing diseases (13)(14)(15)(16)(17) and may not be a specific marker for AD. Kirsch et al (18) reported that hippocampal T2 relaxation time is markedly pro-longed in AD, but other studies have shown it to be only mildly elongated (19,20).…”

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Magnetization transfer measurements of the hippocampus in the early diagnosis of Alzheimer's disease

Hanyu

Asano

Sakurai

et al. 2001

Journal of the Neurological Sciences

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BACKGROUND AND PURPOSE:Although atrophy of structures in the medial temporal lobe has been considered an indication of Alzheimer's disease (AD), atrophic changes on MR images have also been associated with other dementing diseases and are not specific to AD. This study was undertaken to determine whether characteristic alterations in the hippocampus of patients with AD are detectable with magnetization transfer (MT) imaging.METHODS: Coronal MT imaging was performed in 35 patients with probable AD, in 14 patients with vascular dementia, in 13 patients with other types of dementia, and in 23 control subjects to measure MT ratios of the hippocampus. Medial temporal lobe atrophy was graded subjectively on a five-point scale.RESULTS: Scores of medial temporal lobe atrophy in all dementia groups were significantly higher than those in control subjects, but no differences were found among the dementia groups. MT ratios in the hippocampus were significantly lower in patients with AD than in those with non-AD dementia and in the control subjects; however, no differences were found between the non-AD dementia patients and the control subjects. MT ratio measurements were better than visual analysis of atrophy for differentiating AD patients from those with non-AD dementia (an overall discrimination rate of 77% versus 65%). MT ratios significantly correlated with scores on the Mini-Mental State Examination and with medial temporal lobe atrophy in AD patients but not in patients with non-AD dementia.CONCLUSION: MT measurements may be more specific than visual analysis in detecting structural damage of the hippocampus in AD patients and might be useful in discriminating AD from vascular dementia and other types of dementia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Subjectsmentioning

confidence: 99%

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confidence: 99%

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Magnetization transfer measurements of the hippocampus in the early diagnosis of Alzheimer's disease

Hanyu

Asano

Sakurai

et al. 2001

Journal of the Neurological Sciences

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“…While hippocampal atrophy is profound in AD, and AD is possibly the most common cause of hippocampal atrophy, AD is not the only disorder associated with hippocampal atrophy. Disorders such as schizophrenia [10], traumatic brain injury [11], frontotemporal dementia [12], epilepsy [13] and even depression [14] have been associated with some degree of hippocampal volume loss. Sensitivity and specificity values for hippocampal vMRI in AD are commonly reported in the literature relative to healthy elderly patients, but in clinical practice, the comparison group is rather different and consists of patients with other causes of memory impairment.…”

Section: Evaluating Use Of Vmri In the Clinical Settingmentioning

confidence: 99%

Fully-Automated Volumetric MRI with Normative Ranges: Translation to Clinical Practice

Brewer

2009

Behavioural Neurology

101

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Abstract.Neurodegenerative disorders, such as Alzheimer's disease (AD), are associated with characteristic patterns of neuropathological spread in the brain. Disease progression is usually accompanied by regional atrophy that can be detected noninvasively using structural magnetic resonance imaging (MRI). A wealth of data has demonstrated the value of quantitative measurements of regional atrophy in AD, suggesting that volumetric MRI (vMRI) may be a useful clinical tool. vMRI provides biological evidence of neurodegenerative disease in patients with cognitive impairment. However, several hurdles impede implementation of vMRI in clinical practice. These include a lack of standardized MRI acquisition protocols, spatial distortions in MRI data, labor-intensive vMRI methods susceptible to interoperator variability, a lack of normative ranges for volume measures, and difficulty integrating vMRI in clinical workflow. Advances in vMRI have resulted from multi-institutional studies of brain imaging, such as the Alzheimer's Disease Neuroimaging Initiative (ADNI), and help address these challenges. New, fully-automated measures of brain structure volumes coupled with large, multi-center studies using standardized MRI protocols now allow the development of age-adjusted normative ranges for vMRI. Such advances are critical for providing physicians a framework for assessing the pattern and degree of regional atrophy in a patient's brain and applying vMRI in clinical practice.

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Visual Assessment of Atrophy on Magnetic Resonance Imaging in the Diagnosis of Pathologically Confirmed Young-Onset Dementias

Likeman¹,

Anderson²,

Stevens³

et al. 2005

Arch Neurol

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Objectives: To investigate the diagnostic accuracy of visual inspection of magnetic resonance imaging (MRI) in a range of pathologically confirmed diseases causing young-onset dementia and to assess the sensitivity and specificity of atrophy patterns for Alzheimer disease (AD) and frontotemporal lobar degeneration (FTLD). Design: Sixty-two patients with pathologically confirmed diseases that may present as young-onset dementia were selected from a biopsy and postmortem series. The first diagnostic T1-weighted volumetric MRI was obtained for each patient, together with images from 22 healthy control subjects. All MRIs were assessed for regional atrophy independently by 3 neuroradiologists, blinded to all clinical details except age. Observers were also asked to use their clinical judgment to form a diagnosis. Results: Eighty-seven percent of dementia cases were distinguished from controls after visual inspection of MRI, and a correct pathologically confirmed diagnosis was given in 58% of cases. Hippocampal atrophy was noted in 92% of AD cases but was commonly seen in other dementias and controls. A bilateral symmetrical pattern of hippocampal atrophy discriminated AD from FTLD with 47% specificity, while posterior greater than anterior gradient of atrophy was 92% specific for AD. Atrophy of the anterior, inferior, and lateral temporal lobes was suggestive of FTLD pathology (Ն90% sensitivity), while anterior greater than posterior gradient of atrophy and hemispheric asymmetry of atrophy were each at least 85% specific for FTLD. Conclusion: Despite variation and overlap of atrophy patterns, visual inspection of regional atrophy on MRI may aid in discriminating AD and FTLD.

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Hippocampal and entorhinal cortex atrophy in frontotemporal dementia and Alzheimer’s disease

Abstract: At variance with AD, detectable in vivo atrophy of the hippocampus might not be an early event in FTD. Differential patterns of atrophy might help in the diagnostic process of the degenerative dementias.

Cited by 254 publications

References 65 publications

Magnetization transfer measurements of the hippocampus in the early diagnosis of Alzheimer's disease

Magnetization transfer measurements of the hippocampus in the early diagnosis of Alzheimer's disease

Fully-Automated Volumetric MRI with Normative Ranges: Translation to Clinical Practice

Visual Assessment of Atrophy on Magnetic Resonance Imaging in the Diagnosis of Pathologically Confirmed Young-Onset Dementias

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