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01-09-2014 | Neuro

Distinct perfusion patterns in Alzheimer’s disease, frontotemporal dementia and dementia with Lewy bodies

Authors: Maja A. A. Binnewijzend, Joost P. A. Kuijer, Wiesje M. van der Flier, Marije R. Benedictus, Christiane M. Möller, Yolande A. L. Pijnenburg, Afina W. Lemstra, Niels D. Prins, Mike P. Wattjes, Bart N. M. van Berckel, Philip Scheltens, Frederik Barkhof

Published in: European Radiology | Issue 9/2014

Abstract

Objectives

To compare pseudo-continuous arterial spin-labelled (PCASL) magnetic resonance imaging (MRI) measured quantitative cerebral blood flow (CBF) of patients with frontotemporal dementia (FTD), dementia with Lewy Bodies (DLB), Alzheimer’s disease (AD) and controls, in a region of interest (ROI) and voxel-wise fashion.

Methods

We analysed whole-brain 3D fast-spin-echo PCASL images of 20 FTD patients, 14 DLB patients, 48 AD patients and 50 controls from the Amsterdam Dementia Cohort. Regional CBF patterns were compared using analyses of variance for repeated measures. Permutation tests were used for voxel-wise comparisons. Analyses were performed using uncorrected and partial volume corrected (PVC) maps. All analyses were corrected for age and sex.

Results

There was an interaction between diagnosis and region (p < 0.001), implying differences in regional CBF changes between diagnostic groups. In AD patients, CBF was decreased in all supratentorial regions, most prominently so in the posterior regions. DLB patients showed lowest CBF values throughout the brain, but temporal CBF was preserved. Supratentorial PVC cortical CBF values were lowest in the frontal lobes in FTD patients, and in the temporal lobes in AD patients.

Conclusions

Patients with AD, FTD and DLB display distinct patterns of quantitative regional CBF changes. 3D-PCASL may provide additional value in the workup of dementia patients.

Key points

• Patterns of regional CBF changes differ between AD, FTD and DLB patients

• CBF is lower throughout the brain in DLB than AD and FTD

• 3D-PCASL MRI is a potential non-invasive and easily accessible alternative to FDG-PET

• 3D-PCASL MRI may be of additional value in the workup of dementia

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Title: Distinct perfusion patterns in Alzheimer’s disease, frontotemporal dementia and dementia with Lewy bodies
Authors: Maja A. A. Binnewijzend
Joost P. A. Kuijer
Wiesje M. van der Flier
Marije R. Benedictus
Christiane M. Möller
Yolande A. L. Pijnenburg
Afina W. Lemstra
Niels D. Prins
Mike P. Wattjes
Bart N. M. van Berckel
Philip Scheltens
Frederik Barkhof
Publication date: 01-09-2014
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 9/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3172-3

At a glance: The STEP trials

Springer Medicine

Distinct perfusion patterns in Alzheimer’s disease, frontotemporal dementia and dementia with Lewy bodies

Abstract

Objectives

Methods

Results

Conclusions

Key points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key points

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