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Brain perfusion in dementia with Lewy bodies and Alzheimer's disease: an arterial spin labeling MRI study on prodromal and mild dementia stages.

Roquet D, Sourty M, Botzung A, Armspach JP, Blanc F - Alzheimers Res Ther (2016)

Bottom Line: Our results are consistent with previous studies.We extend the scope of those studies by integrating prodromal DLB patients and by describing both hypo- and hyperperfusion in DLB.While decreases in perfusion may relate to functional impairments, increases might suggest a functional compensation of some brain areas.

View Article: PubMed Central - PubMed

Affiliation: ICube laboratory, University of Strasbourg, CNRS, FMTS(Fédération de Médecine Translationnelle de Strasbourg), ICube - IPB, Faculté de Médecine, 4 rue Kirschleger, Strasbourg, 67085, France. daniel.roquet@unistra.fr.

ABSTRACT

Background: We aimed to describe specific changes in brain perfusion in patients with dementia with Lewy bodies (DLB) at both the prodromal (also called mild cognitive impairment) and mild dementia stages, relative to patients with Alzheimer's disease (AD) and controls.

Methods: Altogether, 96 participants in five groups (prodromal DLB, prodromal AD, DLB with mild dementia, AD with mild dementia, and healthy elderly controls) took part in an arterial spin labeling MRI study. Three analyses were performed: a global perfusion value comparison, a voxel-wise analysis of both absolute and relative perfusion, and a linear discriminant analysis. These were used to assess the global decrease in perfusion, regional changes, and the sensitivity and specificity of these changes.

Results: Patterns of perfusion in DLB differed from AD and controls in both the prodromal stage and dementia, DLB having more deficits in frontal, insular, and temporal cortices whereas AD showed reduced perfusion in parietal and parietotemporal cortices. Decreases but also increases of perfusion in DLB relative to controls were observed in both absolute and relative measurements. All these regional changes of perfusion classified DLB patients with respect to either healthy controls or AD with sensitivity from 87 to 100 % and specificity from 90 to 96 % depending on the stage of the disease.

Conclusions: Our results are consistent with previous studies. We extend the scope of those studies by integrating prodromal DLB patients and by describing both hypo- and hyperperfusion in DLB. While decreases in perfusion may relate to functional impairments, increases might suggest a functional compensation of some brain areas.

No MeSH data available.


Related in: MedlinePlus

Statistical maps of relative perfusion in prodromal patients and healthy controls. Numbers are z-coordinates in the MNI space. Left column: Pro DLB minus HC. Middle column: Pro AD minus HC. Right column: Pro DLB minus pro AD. Positive (red) and negative (blue) T-values are, respectively, hyper- and hypoperfusion resulting from a voxel-wise ANOVA (puncorrected<0.001, cluster size threshold of 40 voxels). The anatomical image used as a template is an average T1 from the encompassed groups. AD Alzheimer’s disease, DLB dementia with Lewy bodies, HC healthy (elderly) controls, MNI Montreal National Institute
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Fig1: Statistical maps of relative perfusion in prodromal patients and healthy controls. Numbers are z-coordinates in the MNI space. Left column: Pro DLB minus HC. Middle column: Pro AD minus HC. Right column: Pro DLB minus pro AD. Positive (red) and negative (blue) T-values are, respectively, hyper- and hypoperfusion resulting from a voxel-wise ANOVA (puncorrected<0.001, cluster size threshold of 40 voxels). The anatomical image used as a template is an average T1 from the encompassed groups. AD Alzheimer’s disease, DLB dementia with Lewy bodies, HC healthy (elderly) controls, MNI Montreal National Institute

Mentions: The results for focal relative perfusion in prodromal patients are presented in Table 2 and Fig 1. Hypoperfusion in pro DLB compared to HC occurred in the right frontal, parietal, and temporal cortex together with the anterior insula. Only the left superior frontal gyrus showed an increase in relative perfusion in pro DLB. Absolute hypoperfusion gave similar results with a loss of perfusion in the right temporal and anterior insula, whereas the left superior frontal gyrus was hyperperfused (Additional file 1: Table S1 and Figure S1. Please refer to these supplementary data for all results of absolute perfusion). Pro AD showed hypoperfusion compared to HC in the right inferior frontal gyrus and bilateral angular gyrus, and hyperperfusion was seen in the left supramarginal gyrus (absolute assessment showed a similar pattern of hypoperfusion, but without any increase in perfusion relative to HC). Comparison between pro DLB and pro AD revealed a lower relative perfusion in DLB in the fusiform gyrus (as with absolute measurements). Pro AD did not have any hypoperfused brain areas relative to pro DLB (but absolute measurements showed a decrease in the left angular gyrus).Fig. 1


Brain perfusion in dementia with Lewy bodies and Alzheimer's disease: an arterial spin labeling MRI study on prodromal and mild dementia stages.

Roquet D, Sourty M, Botzung A, Armspach JP, Blanc F - Alzheimers Res Ther (2016)

Statistical maps of relative perfusion in prodromal patients and healthy controls. Numbers are z-coordinates in the MNI space. Left column: Pro DLB minus HC. Middle column: Pro AD minus HC. Right column: Pro DLB minus pro AD. Positive (red) and negative (blue) T-values are, respectively, hyper- and hypoperfusion resulting from a voxel-wise ANOVA (puncorrected<0.001, cluster size threshold of 40 voxels). The anatomical image used as a template is an average T1 from the encompassed groups. AD Alzheimer’s disease, DLB dementia with Lewy bodies, HC healthy (elderly) controls, MNI Montreal National Institute
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940880&req=5

Fig1: Statistical maps of relative perfusion in prodromal patients and healthy controls. Numbers are z-coordinates in the MNI space. Left column: Pro DLB minus HC. Middle column: Pro AD minus HC. Right column: Pro DLB minus pro AD. Positive (red) and negative (blue) T-values are, respectively, hyper- and hypoperfusion resulting from a voxel-wise ANOVA (puncorrected<0.001, cluster size threshold of 40 voxels). The anatomical image used as a template is an average T1 from the encompassed groups. AD Alzheimer’s disease, DLB dementia with Lewy bodies, HC healthy (elderly) controls, MNI Montreal National Institute
Mentions: The results for focal relative perfusion in prodromal patients are presented in Table 2 and Fig 1. Hypoperfusion in pro DLB compared to HC occurred in the right frontal, parietal, and temporal cortex together with the anterior insula. Only the left superior frontal gyrus showed an increase in relative perfusion in pro DLB. Absolute hypoperfusion gave similar results with a loss of perfusion in the right temporal and anterior insula, whereas the left superior frontal gyrus was hyperperfused (Additional file 1: Table S1 and Figure S1. Please refer to these supplementary data for all results of absolute perfusion). Pro AD showed hypoperfusion compared to HC in the right inferior frontal gyrus and bilateral angular gyrus, and hyperperfusion was seen in the left supramarginal gyrus (absolute assessment showed a similar pattern of hypoperfusion, but without any increase in perfusion relative to HC). Comparison between pro DLB and pro AD revealed a lower relative perfusion in DLB in the fusiform gyrus (as with absolute measurements). Pro AD did not have any hypoperfused brain areas relative to pro DLB (but absolute measurements showed a decrease in the left angular gyrus).Fig. 1

Bottom Line: Our results are consistent with previous studies.We extend the scope of those studies by integrating prodromal DLB patients and by describing both hypo- and hyperperfusion in DLB.While decreases in perfusion may relate to functional impairments, increases might suggest a functional compensation of some brain areas.

View Article: PubMed Central - PubMed

Affiliation: ICube laboratory, University of Strasbourg, CNRS, FMTS(Fédération de Médecine Translationnelle de Strasbourg), ICube - IPB, Faculté de Médecine, 4 rue Kirschleger, Strasbourg, 67085, France. daniel.roquet@unistra.fr.

ABSTRACT

Background: We aimed to describe specific changes in brain perfusion in patients with dementia with Lewy bodies (DLB) at both the prodromal (also called mild cognitive impairment) and mild dementia stages, relative to patients with Alzheimer's disease (AD) and controls.

Methods: Altogether, 96 participants in five groups (prodromal DLB, prodromal AD, DLB with mild dementia, AD with mild dementia, and healthy elderly controls) took part in an arterial spin labeling MRI study. Three analyses were performed: a global perfusion value comparison, a voxel-wise analysis of both absolute and relative perfusion, and a linear discriminant analysis. These were used to assess the global decrease in perfusion, regional changes, and the sensitivity and specificity of these changes.

Results: Patterns of perfusion in DLB differed from AD and controls in both the prodromal stage and dementia, DLB having more deficits in frontal, insular, and temporal cortices whereas AD showed reduced perfusion in parietal and parietotemporal cortices. Decreases but also increases of perfusion in DLB relative to controls were observed in both absolute and relative measurements. All these regional changes of perfusion classified DLB patients with respect to either healthy controls or AD with sensitivity from 87 to 100 % and specificity from 90 to 96 % depending on the stage of the disease.

Conclusions: Our results are consistent with previous studies. We extend the scope of those studies by integrating prodromal DLB patients and by describing both hypo- and hyperperfusion in DLB. While decreases in perfusion may relate to functional impairments, increases might suggest a functional compensation of some brain areas.

No MeSH data available.


Related in: MedlinePlus