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    Longitudinal assessment of global and regional atrophy rates in Alzheimer's disease and dementia with Lewy bodies

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    Author
    Mak, E; Su, L; Williams, GB; Watson, R; Firbank, M; Blamire, AM; OBrien, JT
    Date
    2015-01-01
    Source Title
    NeuroImage: Clinical
    Publisher
    ELSEVIER SCI LTD
    University of Melbourne Author/s
    Watson, Rosemary
    Affiliation
    Medicine and Radiology
    Metadata
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    Document Type
    Journal Article
    Citations
    Mak, E., Su, L., Williams, G. B., Watson, R., Firbank, M., Blamire, A. M. & OBrien, J. T. (2015). Longitudinal assessment of global and regional atrophy rates in Alzheimer's disease and dementia with Lewy bodies. NEUROIMAGE-CLINICAL, 7, pp.456-462. https://doi.org/10.1016/j.nicl.2015.01.017.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/256212
    DOI
    10.1016/j.nicl.2015.01.017
    Abstract
    BACKGROUND & OBJECTIVE: Percent whole brain volume change (PBVC) measured from serial MRI scans is widely accepted as a sensitive marker of disease progression in Alzheimer's disease (AD). However, the utility of PBVC in the differential diagnosis of dementia remains to be established. We compared PBVC in AD and dementia with Lewy bodies (DLB), and investigated associations with clinical measures. METHODS: 72 participants (14 DLBs, 25 ADs, and 33 healthy controls (HCs)) underwent clinical assessment and 3 Tesla T1-weighted MRI at baseline and repeated at 12 months. We used FSL-SIENA to estimate PBVC for each subject. Voxelwise analyses and ANCOVA compared PBVC between DLB and AD, while correlational tests examined associations of PBVC with clinical measures. RESULTS: AD had significantly greater atrophy over 1 year (1.8%) compared to DLB (1.0%; p = 0.01) and HC (0.9%; p < 0.01) in widespread regions of the brain including periventricular areas. PBVC was not significantly different between DLB and HC (p = 0.95). There were no differences in cognitive decline between DLB and AD. In the combined dementia group (AD and DLB), younger age was associated with higher atrophy rates (r = 0.49, p < 0.01). CONCLUSIONS: AD showed a faster rate of global brain atrophy compared to DLB, which had similar rates of atrophy to HC. Among dementia subjects, younger age was associated with accelerated atrophy, reflecting more aggressive disease in younger people. PBVC could aid in differentiating between DLB and AD, however its utility as an outcome marker in DLB is limited.

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