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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1996 Aug;61(2):157–165. doi: 10.1136/jnnp.61.2.157

Brain atrophy in frontotemporal dementia.

G B Frisoni 1, A Beltramello 1, C Geroldi 1, C Weiss 1, A Bianchetti 1, M Trabucchi 1
PMCID: PMC1073989  PMID: 8708683

Abstract

OBJECTIVES--To evaluate the pattern of regional brain atrophy in patients with frontotemporal dementia by comparing it with that in patients with Alzheimer's disease and normal controls. METHODS--Fourteen patients with frontotemporal dementia, 13 with moderate, and 33 with mild Alzheimer's disease, and 31 controls were studied. Atrophy was evaluated with linear measures in the anterior brain, medial temporal lobe, and hippocampal formation regions using MRI. RESULTS--Patients with frontotemporal dementia had greater atrophy in the anterior brain regions than patients with Alzheimer's disease or controls. Atrophy of the hippocampal formation, which best discriminates Alzheimer's disease from controls, was present also in patients with frontotemporal dementia. By contrast, atrophy of the medial temporal lobe, which is also present in Alzheimer's disease, was absent in frontotemporal dementia. CONCLUSION--A pattern of atrophy in the frontal lobes and hippocampal formation with sparing of the medial temporal lobe might be distinctive of frontotemporal dementia. Hippocampal involvement might not be specific for Alzheimer's disease and specific patterns of atrophy might be distinctive of some forms of degenerative dementia.

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  1. Barr A. N., Heinze W. J., Dobben G. D., Valvassori G. E., Sugar O. Bicaudate index in computerized tomography of Huntington disease and cerebral atrophy. Neurology. 1978 Nov;28(11):1196–1200. doi: 10.1212/wnl.28.11.1196. [DOI] [PubMed] [Google Scholar]
  2. Binetti G., Magni E., Padovani A., Cappa S. F., Bianchetti A., Trabucchi M. Neuropsychological heterogeneity in mild Alzheimer's disease. Dementia. 1993 Nov-Dec;4(6):321–326. doi: 10.1159/000107340. [DOI] [PubMed] [Google Scholar]
  3. Cascino G. D., Jack C. R., Jr, Parisi J. E., Sharbrough F. W., Hirschorn K. A., Meyer F. B., Marsh W. R., O'Brien P. C. Magnetic resonance imaging-based volume studies in temporal lobe epilepsy: pathological correlations. Ann Neurol. 1991 Jul;30(1):31–36. doi: 10.1002/ana.410300107. [DOI] [PubMed] [Google Scholar]
  4. Coffey C. E., Wilkinson W. E., Parashos I. A., Soady S. A., Sullivan R. J., Patterson L. J., Figiel G. S., Webb M. C., Spritzer C. E., Djang W. T. Quantitative cerebral anatomy of the aging human brain: a cross-sectional study using magnetic resonance imaging. Neurology. 1992 Mar;42(3 Pt 1):527–536. doi: 10.1212/wnl.42.3.527. [DOI] [PubMed] [Google Scholar]
  5. Dahlbeck J. W., McCluney K. W., Yeakley J. W., Fenstermacher M. J., Bonmati C., Van Horn G., 3rd, Aldag J. The interuncal distance: a new MR measurement for the hippocampal atrophy of Alzheimer disease. AJNR Am J Neuroradiol. 1991 Sep-Oct;12(5):931–932. [PMC free article] [PubMed] [Google Scholar]
  6. DeCarli C., Murphy D. G., McIntosh A. R., Teichberg D., Schapiro M. B., Horwitz B. Discriminant analysis of MRI measures as a method to determine the presence of dementia of the Alzheimer type. Psychiatry Res. 1995 Jul 28;57(2):119–130. doi: 10.1016/0165-1781(95)02651-c. [DOI] [PubMed] [Google Scholar]
  7. Erkinjuntti T., Lee D. H., Gao F., Steenhuis R., Eliasziw M., Fry R., Merskey H., Hachinski V. C. Temporal lobe atrophy on magnetic resonance imaging in the diagnosis of early Alzheimer's disease. Arch Neurol. 1993 Mar;50(3):305–310. doi: 10.1001/archneur.1993.00540030069017. [DOI] [PubMed] [Google Scholar]
  8. Folstein M. F., Folstein S. E., McHugh P. R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6. [DOI] [PubMed] [Google Scholar]
  9. Frisoni G. B., Beltramello A., Weiss C., Geroldi C., Bianchetti A., Trabucchi M. Usefulness of simple measures of temporal lobe atrophy in probable Alzheimer's disease. Dementia. 1996 Jan-Feb;7(1):15–22. doi: 10.1159/000106847. [DOI] [PubMed] [Google Scholar]
  10. Frisoni G. B., Bianchetti A., Geroldi C., Trabucchi M., Beltramello A., Weiss C. Measures of medial temporal lobe atrophy in Alzheimer's disease. J Neurol Neurosurg Psychiatry. 1994 Nov;57(11):1438–1439. doi: 10.1136/jnnp.57.11.1438. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Frisoni G. B., Bianchetti A., Govoni S., Trabucchi M., Calabresi L., Franceschini G. Association of apolipoprotein E E4 with vascular dementia. JAMA. 1994 May 4;271(17):1317–1317. [PubMed] [Google Scholar]
  12. Frisoni G. B., Govoni S., Geroldi C., Bianchetti A., Calabresi L., Franceschini G., Trabucchi M. Gene dose of the epsilon 4 allele of apolipoprotein E and disease progression in sporadic late-onset Alzheimer's disease. Ann Neurol. 1995 May;37(5):596–604. doi: 10.1002/ana.410370509. [DOI] [PubMed] [Google Scholar]
  13. Frisoni G. B., Pizzolato G., Geroldi C., Rossato A., Bianchetti A., Trabucchi M. Dementia of the frontal type: neuropsychological and [99Tc]-HM-PAO SPET features. J Geriatr Psychiatry Neurol. 1995 Jan;8(1):42–48. [PubMed] [Google Scholar]
  14. Gur R. C., Mozley P. D., Resnick S. M., Gottlieb G. L., Kohn M., Zimmerman R., Herman G., Atlas S., Grossman R., Berretta D. Gender differences in age effect on brain atrophy measured by magnetic resonance imaging. Proc Natl Acad Sci U S A. 1991 Apr 1;88(7):2845–2849. doi: 10.1073/pnas.88.7.2845. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Gustafson L. Clinical picture of frontal lobe degeneration of non-Alzheimer type. Dementia. 1993 May-Aug;4(3-4):143–148. doi: 10.1159/000107313. [DOI] [PubMed] [Google Scholar]
  16. Hughes C. P., Berg L., Danziger W. L., Coben L. A., Martin R. L. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982 Jun;140:566–572. doi: 10.1192/bjp.140.6.566. [DOI] [PubMed] [Google Scholar]
  17. Jack C. R., Jr, Petersen R. C., O'Brien P. C., Tangalos E. G. MR-based hippocampal volumetry in the diagnosis of Alzheimer's disease. Neurology. 1992 Jan;42(1):183–188. doi: 10.1212/wnl.42.1.183. [DOI] [PubMed] [Google Scholar]
  18. Jobst K. A., Smith A. D., Szatmari M., Molyneux A., Esiri M. E., King E., Smith A., Jaskowski A., McDonald B., Wald N. Detection in life of confirmed Alzheimer's disease using a simple measurement of medial temporal lobe atrophy by computed tomography. Lancet. 1992 Nov 14;340(8829):1179–1183. doi: 10.1016/0140-6736(92)92890-r. [DOI] [PubMed] [Google Scholar]
  19. Katz S., Downs T. D., Cash H. R., Grotz R. C. Progress in development of the index of ADL. Gerontologist. 1970 Spring;10(1):20–30. doi: 10.1093/geront/10.1_part_1.20. [DOI] [PubMed] [Google Scholar]
  20. Knopman D. S., Christensen K. J., Schut L. J., Harbaugh R. E., Reeder T., Ngo T., Frey W., 2nd The spectrum of imaging and neuropsychological findings in Pick's disease. Neurology. 1989 Mar;39(3):362–368. doi: 10.1212/wnl.39.3.362. [DOI] [PubMed] [Google Scholar]
  21. Knopman D. S., Mastri A. R., Frey W. H., 2nd, Sung J. H., Rustan T. Dementia lacking distinctive histologic features: a common non-Alzheimer degenerative dementia. Neurology. 1990 Feb;40(2):251–256. doi: 10.1212/wnl.40.2.251. [DOI] [PubMed] [Google Scholar]
  22. Lawton M. P., Brody E. M. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969 Autumn;9(3):179–186. [PubMed] [Google Scholar]
  23. Leigh P. N., Ray-Chaudhuri K. Motor neuron disease. J Neurol Neurosurg Psychiatry. 1994 Aug;57(8):886–896. doi: 10.1136/jnnp.57.8.886. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Mann D. M., South P. W., Snowden J. S., Neary D. Dementia of frontal lobe type: neuropathology and immunohistochemistry. J Neurol Neurosurg Psychiatry. 1993 Jun;56(6):605–614. doi: 10.1136/jnnp.56.6.605. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. McKeith I. G., Fairbairn A. F., Bothwell R. A., Moore P. B., Ferrier I. N., Thompson P., Perry R. H. An evaluation of the predictive validity and inter-rater reliability of clinical diagnostic criteria for senile dementia of Lewy body type. Neurology. 1994 May;44(5):872–877. doi: 10.1212/wnl.44.5.872. [DOI] [PubMed] [Google Scholar]
  26. McKhann G., Drachman D., Folstein M., Katzman R., Price D., Stadlan E. M. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984 Jul;34(7):939–944. doi: 10.1212/wnl.34.7.939. [DOI] [PubMed] [Google Scholar]
  27. Mendez M. F., Zander B. A. Dementia presenting with aphasia: clinical characteristics. J Neurol Neurosurg Psychiatry. 1991 Jun;54(6):542–545. doi: 10.1136/jnnp.54.6.542. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Miller B. L., Cummings J. L., Villanueva-Meyer J., Boone K., Mehringer C. M., Lesser I. M., Mena I. Frontal lobe degeneration: clinical, neuropsychological, and SPECT characteristics. Neurology. 1991 Sep;41(9):1374–1382. doi: 10.1212/wnl.41.9.1374. [DOI] [PubMed] [Google Scholar]
  29. Neary D., Snowden J. S., Mann D. M. The clinical pathological correlates of lobar atrophy. Dementia. 1993 May-Aug;4(3-4):154–159. doi: 10.1159/000107315. [DOI] [PubMed] [Google Scholar]
  30. Powers W. J., Perlmutter J. S., Videen T. O., Herscovitch P., Griffeth L. K., Royal H. D., Siegel B. A., Morris J. C., Berg L. Blinded clinical evaluation of positron emission tomography for diagnosis of probable Alzheimer's disease. Neurology. 1992 Apr;42(4):765–770. doi: 10.1212/wnl.42.4.765. [DOI] [PubMed] [Google Scholar]
  31. Risberg J., Passant U., Warkentin S., Gustafson L. Regional cerebral blood flow in frontal lobe dementia of non-Alzheimer type. Dementia. 1993 May-Aug;4(3-4):186–187. doi: 10.1159/000107321. [DOI] [PubMed] [Google Scholar]
  32. Saunders A. M., Strittmatter W. J., Schmechel D., George-Hyslop P. H., Pericak-Vance M. A., Joo S. H., Rosi B. L., Gusella J. F., Crapper-MacLachlan D. R., Alberts M. J. Association of apolipoprotein E allele epsilon 4 with late-onset familial and sporadic Alzheimer's disease. Neurology. 1993 Aug;43(8):1467–1472. doi: 10.1212/wnl.43.8.1467. [DOI] [PubMed] [Google Scholar]
  33. Scheltens P., Leys D., Barkhof F., Huglo D., Weinstein H. C., Vermersch P., Kuiper M., Steinling M., Wolters E. C., Valk J. Atrophy of medial temporal lobes on MRI in "probable" Alzheimer's disease and normal ageing: diagnostic value and neuropsychological correlates. J Neurol Neurosurg Psychiatry. 1992 Oct;55(10):967–972. doi: 10.1136/jnnp.55.10.967. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Shenton M. E., Kikinis R., Jolesz F. A., Pollak S. D., LeMay M., Wible C. G., Hokama H., Martin J., Metcalf D., Coleman M. Abnormalities of the left temporal lobe and thought disorder in schizophrenia. A quantitative magnetic resonance imaging study. N Engl J Med. 1992 Aug 27;327(9):604–612. doi: 10.1056/NEJM199208273270905. [DOI] [PubMed] [Google Scholar]
  35. Tanna N. K., Kohn M. I., Horwich D. N., Jolles P. R., Zimmerman R. A., Alves W. M., Alavi A. Analysis of brain and cerebrospinal fluid volumes with MR imaging: impact on PET data correction for atrophy. Part II. Aging and Alzheimer dementia. Radiology. 1991 Jan;178(1):123–130. doi: 10.1148/radiology.178.1.1984290. [DOI] [PubMed] [Google Scholar]
  36. Wahlund L. O., Andersson-Lundman G., Basun H., Almkvist O., Björkstén K. S., Säf J., Wetterberg L. Cognitive functions and brain structures: a quantitative study of CSF volumes on Alzheimer patients and healthy control subjects. Magn Reson Imaging. 1993;11(2):169–174. doi: 10.1016/0730-725x(93)90021-5. [DOI] [PubMed] [Google Scholar]

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