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AJNR - American Journal of Neuroradiology

Publication Preview: Published April 3, 2009

American Journal of Neuroradiology 2009;30:1233.

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American Journal of Neuroradiology
DOI 10.3174/ajnr.A1545

BRAIN

Cortical Morphometric Subclassification of Frontotemporal Lobar Degeneration

O. Lindberg, P. Östberg, B.B. Zandbelt, J. Öberg, Y. Zhang, C. Andersen, J.C.L. Looi, N. Bogdanovi and L.-O. Wahlund

From the Department of Neurobiology, Care Science and Society (O.L., P. Ö., B.B.Z., C.A., N.B., L.-O.W.), Section of Clinical Geriatrics, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology (J.Ö., Y.Z.), Karolinska Institute, Stockholm, Sweden; Academic Unit of Psychological Medicine (J.C.L.L.), Australian National University Medical School, Canberra, Australia. Dr. Zandbelt is now with the Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, the Netherlands.

Please address correspondence to Lars-Olof Wahlund, MD, Division of Clinical Geriatrics, Department of Neurobiology, Health Care Science and Society, Karolinska Institute, Novum Science Park, Floor 5, SE-14186 Stockholm, Sweden; e-mail: lars-olof.wahlund{at}ki.se

BACKGROUND AND PURPOSE: Frontotemporal lobar degeneration (FTLD) is a primary neurodegenerative disease comprising 3 clinical subtypes: frontotemporal dementia (FTD), semantic dementia (SD), and progressive nonfluent aphasia (PNFA). The subdivision is primarily based on the characteristic clinical symptoms displayed by each subtype. We hypothesized that these symptoms would be correlated to characteristic patterns of brain atrophy, which could be indentified and used for subclassification of subjects with FTLD.

MATERIALS AND METHODS: Volumes of 9 cortical regions were manually parcellated and measured on both hemispheres on 27 controls, 12 patients with FTD, 9 patients with PNFA, and 13 patients with SD. The volumetric data were analyzed by traditional t tests and by a multivariate discriminant analysis (partial least squares discriminant analysis).

RESULTS: The ensemble or pattern of atrophy was a good discriminator in pair-wise comparison between the subtypes: FTD compared with SD (sensitivity 100% [12/12], specificity 100% [13/13]); FTD compared with PNFA (sensitivity 92% [11/12], specificity 89% [8/9]); and SD compared with PNFA (sensitivity 86% [11/13], specificity 100% [9/9]). Temporal-versus-frontal atrophy was the most important pattern for discriminating SD from the other 2 subtypes. Right-sided versus left-sided atrophy was the most important pattern for discriminating between subjects with FTD and PNFA.

CONCLUSIONS: FTLD subtypes generally display a characteristic pattern of atrophy, which may be considered in diagnosing patients with FTLD.

This article has been cited by other articles:

				J.C.L. Looi, L. Svensson, O. Lindberg, B.B. Zandbelt, P. Ostberg, E. Orndahl, and L.-O. Wahlund Putaminal Volume in Frontotemporal Lobar Degeneration and Alzheimer Disease: Differential Volumes in Dementia Subtypes and Controls AJNR Am. J. Neuroradiol., September 1, 2009; 30(8): 1552 - 1560. [Abstract] [Full Text] [PDF]