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Neurobiol Aging. 2015 Jan;36(1):452-61. doi: 10.1016/j.neurobiolaging.2014.07.005. Epub 2014 Jul 15.

Pattern of brain atrophy rates in autopsy-confirmed dementia with Lewy bodies.

Author information

1
Department of Radiology, Mayo Clinic, Rochester, MN, USA; Department of Neurology, 2nd Faculty of Medicine and Motol University Hospital, Charles University in Prague, Prague, the Czech Republic; International Clinical Research Center, St. Anne's University Hospital Brno, Brno, the Czech Republic.
2
Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA.
3
Department of Neurology, Mayo Clinic, Rochester, MN, USA.
4
Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
5
Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA.
6
Department of Radiology, Mayo Clinic, Rochester, MN, USA.
7
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
8
Department of Psychiatry and Psychology, Mayo Clinic, Scottsdale, AZ, USA; Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA.
9
Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, MN, USA.
10
Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA; Neuropathology Laboratory, Mayo Clinic, Jacksonville, FL, USA.
11
Department of Radiology, Mayo Clinic, Rochester, MN, USA. Electronic address: kantarci.kejal@mayo.edu.

Abstract

Dementia with Lewy bodies (DLB) is characterized by preserved whole brain and medial temporal lobe volumes compared with Alzheimer's disease dementia (AD) on magnetic resonance imaging. However, frequently coexistent AD-type pathology may influence the pattern of regional brain atrophy rates in DLB patients. We investigated the pattern and magnitude of the atrophy rates from 2 serial MRIs in autopsy-confirmed DLB patients (n = 20) and mixed DLB/AD patients (n = 22), compared with AD (n = 30) and elderly nondemented control subjects (n = 15), followed antemortem. DLB patients without significant AD-type pathology were characterized by lower global and regional rates of atrophy, similar to control subjects. The mixed DLB/AD patients displayed greater atrophy rates in the whole brain, temporoparietal cortices, hippocampus and amygdala, and ventricle expansion, similar to AD patients. In the DLB and DLB/AD patients, the atrophy rates correlated with Braak neurofibrillary tangle stage, cognitive decline, and progression of motor symptoms. Global and regional atrophy rates are associated with AD-type pathology in DLB, and these rates can be used as biomarkers of AD progression in patients with LB pathology.

KEYWORDS:

Alzheimer's disease; Atrophy rate; Autopsy-confirmed dementia with Lewy bodies; Braak neurofibrillary tangle stage; Sample size estimate; Serial MRI

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