Neurobiol Aging. 2014 Jul 15. pii: S0197-4580(14)00474-6. doi: 10.1016/j.neurobiolaging.2014.07.005. [Epub ahead of print]

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

Nedelska Z1, Ferman TJ2, Boeve BF3, Przybelski SA4, Lesnick TG4, Murray ME5, Gunter JL6, Senjem ML6, Vemuri P6, Smith GE7, Geda YE8, Graff-Radford J3,Knopman DS3, Petersen RC3, Parisi JE9, Dickson DW10, Jack CR Jr6, Kantarci K11.

Author information

• 1Department 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.
• 2Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA.
• 3Department of Neurology, Mayo Clinic, Rochester, MN, USA.
• 4Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
• 5Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA.
• 6Department of Radiology, Mayo Clinic, Rochester, MN, USA.
• 7Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
• 8Department of Psychiatry and Psychology, Mayo Clinic, Scottsdale, AZ, USA; Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA.
• 9Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, MN, USA.
• 10Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA; Neuropathology Laboratory, Mayo Clinic, Jacksonville, FL, USA.
• 11Department 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.