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Subcortical atrophy in dementia with Lewy bodies
Author(s) -
Philippi Nathalie,
Noblet Vincent,
Botzung Anne,
Blanc Frédéric
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.042145
Subject(s) - dementia with lewy bodies , atrophy , medicine , cardiology , dementia , cerebral cortex , psychology , alzheimer's disease , pathology , neuroscience , disease
Background Dementia with Lewy bodies (DLB) is typically associated to less pronounced cortical atrophy than Alzheimer’s disease (AD). However, our clinical experience suggests that DLB patients have a prominent subcortical atrophy, contrasting with overall preserved neocortical and hippocampal regions. Therefore, the objective of the present study was to test the existence of a subcortical atrophy in DLB patients as compared to AD patients and normal controls. We hypothesized that patients with DLB would have larger ventricular volumes than AD patients and controls, at least when considering the ventricular volume relatively to the global cortical volume. Method We included 55 DLB patients (30 mild to moderate [d‐DLB], 25 prodromal [pro‐DLB]), and compared their cerebral volumes to those of 51 AD patients (31 mild to moderate [d‐AD], 20 prodromal [pro‐AD]), matched for age, educational level and MMSE scores, and to those of 17 healthy control subjects (CS), matched for age and educational level. Total ventricular volume (TVV) volumes were extracted using freesurfer. We also examine the ratio of the TVV against the total cortical volume (Cortex). We included Total intracranial volume and age as nuisance covariates. Result We found that both d‐DLB group( p = 0.003) and pro‐DLB group ( p = 0.006) had significantly higher TVV compared to the CS. Compared to the AD patients, TVV was significantly higher in the d‐DLB group vs . the d‐AD group ( p = 0.03), though, only at the level of a trend in the pro‐DLB group vs . pro‐AD group ( p = 0.055). As for the TVV/Cortex ratio, a significant difference was found for the DLB groups compared to both CS (d‐DLB: p = 0.002; pro‐DLB: p = 0.004) and AD groups (d‐DLB vs . d‐AD: p = 0.03; pro‐DLB vs . pro‐AD: p = 0.04). Conclusion DLB patients have higher ventricular volumes compared to healthy controls and AD patients, reflecting a larger subcortical atrophy. This was more particularly the case when considering the ventricular volume relatively to the global cortical volume, which suggests it could serve as a potential biomarker for the differential diagnosis between DLB and AD patients, even at the prodromal stage.