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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 patients with mild dementia and healthy controls. Numbers are z-coordinates in the MNI space. Left column: Mild DLB minus HC. Middle column: Mild AD minus HC. Right column: Mild DLB minus mild 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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Fig2: Statistical maps of relative perfusion in patients with mild dementia and healthy controls. Numbers are z-coordinates in the MNI space. Left column: Mild DLB minus HC. Middle column: Mild AD minus HC. Right column: Mild DLB minus mild 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: Mild DLB patients showed a variety of hypoperfused brain areas compared to HC (Table 3 and Fig 2), including the frontal and temporal cortex, bilateral anterior insula, and caudate nucleus (as in absolute measurement; see Additional file 1: Table S2 and Figure S2). Hyperperfusion in mild DLB patients was observed mainly in the left precuneus. In mild AD, compared to HC, perfusion was reduced in parietal and temporal areas (assessment of absolute perfusion provided a similar pattern), whereas hyperperfusion was restricted to the left putamen (no increases in mild AD were revealed with absolute perfusion). When patient groups were compared, mild DLB showed a lower perfusion than mild AD in the frontal and temporal cortices together with the left supramarginal gyrus, anterior insula, and caudate nucleus (a difference in absolute perfusion only concerned the anterior insula and the supramarginal and superior temporal gyri). In contrast, mild AD had a reduced rCBF in the bilateral precuneus, left supramarginal, and medial superior frontal gyri (only the bilateral precuneus and the left supramarginal gyrus in assessment of absolute perfusion).Fig. 2


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 patients with mild dementia and healthy controls. Numbers are z-coordinates in the MNI space. Left column: Mild DLB minus HC. Middle column: Mild AD minus HC. Right column: Mild DLB minus mild 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

Fig2: Statistical maps of relative perfusion in patients with mild dementia and healthy controls. Numbers are z-coordinates in the MNI space. Left column: Mild DLB minus HC. Middle column: Mild AD minus HC. Right column: Mild DLB minus mild 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: Mild DLB patients showed a variety of hypoperfused brain areas compared to HC (Table 3 and Fig 2), including the frontal and temporal cortex, bilateral anterior insula, and caudate nucleus (as in absolute measurement; see Additional file 1: Table S2 and Figure S2). Hyperperfusion in mild DLB patients was observed mainly in the left precuneus. In mild AD, compared to HC, perfusion was reduced in parietal and temporal areas (assessment of absolute perfusion provided a similar pattern), whereas hyperperfusion was restricted to the left putamen (no increases in mild AD were revealed with absolute perfusion). When patient groups were compared, mild DLB showed a lower perfusion than mild AD in the frontal and temporal cortices together with the left supramarginal gyrus, anterior insula, and caudate nucleus (a difference in absolute perfusion only concerned the anterior insula and the supramarginal and superior temporal gyri). In contrast, mild AD had a reduced rCBF in the bilateral precuneus, left supramarginal, and medial superior frontal gyri (only the bilateral precuneus and the left supramarginal gyrus in assessment of absolute perfusion).Fig. 2

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