scholarly journals Characteristics of Cortical Atrophy and White Matter Lesions Between Dementia With Lewy Bodies and Alzheimer's Disease: A Case-Control Study

2022 ◽  
Vol 12 ◽  
Author(s):  
Han Zhu ◽  
Hao Lu ◽  
Fei Wang ◽  
Shuai Liu ◽  
Zhihong Shi ◽  
...  
Keyword(s):  
White Matter ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Dementia With Lewy Bodies ◽  
Rating Scales ◽  
Lewy Bodies ◽  
White Matter Lesions ◽  
Cortical Atrophy ◽  
Visual Rating ◽  
Normal Controls

Introduction: Currently, there is still clinical overlap between dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) patients, which may affect the accuracy of the early diagnosis of DLB. For better diagnosis and prognosis, further exploration of local cortical atrophy patterns and white matter lesions is needed.Methods: We reviewed the outpatient medical records of 97 DLB patients and 173 AD patients from January 2018 to September 2020 along with 30 matched outpatient clinic normal elderly people. MRI visual rating scales, including medial temporal lobe atrophy (MTA), global cortical atrophy-frontal subscale (GCA-F), posterior atrophy (PA), Fazekas scale, Evans Index and cerebral microbleeds were evaluated and analyzed in DLB and AD patients with different severities and normal controls.Results: Overall, patients with DLB had higher scores on all visual rating scales than the normal controls. Meanwhile, compared with AD, DLB had lower MTA scores in the mild to moderate groups (both p ≤ 0.001), but the GCA-F and PA scores were similar (all p > 0.05). The Fazekas scores in the moderate to severe DLB group were lower than those in the AD group (p = 0.024 and p = 0.027, respectively). In addition, the diagnostic performance and sensitivity of multiple imaging indicators for DLB were better than that of MTA alone (the combination of MTA, GCA-F, PA, Fazekas visual rating scales, AUC = 0.756, 95%CI: 0.700–0.813, sensitivity = 0.647, specificity = 0.804 and MTA visual rating scale, AUC = 0.726, 95%CI: 0.667–0.785, sensitivity = 0.497, specificity = 0.876, respectively).Conclusion: The medial temporal lobe of DLB patients was relatively preserved, the frontal and parietal lobes were similarly atrophied to AD patients, and the white matter hyperintensity was lighter than that in AD patients. Combined multiple visual rating scales may provide a novel idea for the diagnosis of early DLB.

Association between blood pressure, white matter lesions, and atrophy of the medial temporal lobe

Neurology ◽  
2005 ◽  
Vol 64 (2) ◽  
pp. 263-267 ◽  
Author(s):  
T. den Heijer ◽  
L. J. Launer ◽  
N. D. Prins ◽  
E. J. van Dijk ◽  
S. E. Vermeer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
White Matter Lesions

Neurosyphilis: mighty imitator forays with benign presentation and unique neuroimaging findings

Sexual Health ◽  
2018 ◽  
Vol 15 (4) ◽  
pp. 358 ◽  
Author(s):  
Harmanpreet Tiwana ◽  
Aiesha Ahmed
Keyword(s):  
White Matter ◽  
Temporal Lobe ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Treponema Pallidum ◽  
White Matter Lesions ◽  
Vascular Pathology ◽  
Cortical Atrophy ◽  
Neck Stiffness ◽  
Fluid Attenuated Inversion Recovery

Background Common causes of temporal lobe hyper intensities are central nervous system infections like herpes simplex encephalitis, Lyme disease, limbic encephalitis and vascular pathology like Cerebral Autosomal Dominant Arteriopathy with Subcortical infarcts and Leukoencephalopathy. Methods: Personal assessment, laboratory data analysis and neuroimaging for the patient who was admitted to a central Pennsylvania tertiary care referral centre were conducted. Results: A 52-year-old male presented with a 1-year history of diffuse dysesthesia in upper and lower extremities with associated intermittent headaches and neck stiffness. Evaluation with lumbar puncture revealed increased nucleated cells (50 ul) with lymphocytic predominance (96%) and an elevated protein level of 109 mg/dl. Magnetic resonance imaging (MRI) of the brain showed T2/FLAIR hyper intensity in bilateral subcortical temporal white matter, left-greater-than-right and associated volume loss in cerebral parenchyma. Additional abnormal work up included reactive serum reactive plasma regain and Treponema pallidum antibody particle agglutination. Diagnosis of neurosyphilis was made and the patient was treated with intramuscular (IM) penicillin for 3 weeks. At the time of discharge, his headache and neck stiffness resolved and dysesthesias were decreased in intensity. Conclusions: The diagnosis of neurosyphilis is intricate, and no reference standard exists. Neuroimaging findings of neurosyphilis commonly are cerebral infarctions, leptomeningeal enhancement or non-specific white matter lesions. Less common features on fluid-attenuated inversion recovery (FLAIR) sequences are cortical atrophy and mesial temporal parenchymal signal changes. It is prudent to keep neurosyphilis in differential of mesial temporal lobe white matter changes, as early diagnosis and treatment results in better prognosis.

High Resolution Imaging of the Medial Temporal Lobe in Alzheimer's Disease and Dementia with Lewy Bodies

2010 ◽  
Vol 21 (4) ◽  
pp. 1129-1140 ◽  
Author(s):  
Michael J. Firbank ◽  
Andrew M. Blamire ◽  
Andrew Teodorczuk ◽  
Emma Teper ◽  
Emma J. Burton ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
High Resolution ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
High Resolution Imaging ◽  
Resolution Imaging

Patterns of gray matter atrophy in dementia with Lewy bodies: a voxel-based morphometry study

2011 ◽  
Vol 24 (4) ◽  
pp. 532-540 ◽  
Author(s):  
Rosie Watson ◽  
John T. O'Brien ◽  
Robert Barber ◽  
Andrew M. Blamire
Keyword(s):  
Temporal Lobe ◽  
Gray Matter ◽  
Medial Temporal Lobe ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Imaging Biomarker ◽  
Voxel Based Morphometry ◽  
Subcortical Structures ◽  
Gray Matter Atrophy ◽  
Lobe Atrophy

ABSTRACTBackground: Dementia with Lewy bodies (DLB) is a common form of dementia characterized by visual hallucinations, cognitive fluctuation and parkinsonism. We aimed to compare the patterns of gray matter atrophy in DLB with those in Alzheimer's disease (AD) and normal aging, and to investigate the relationship between atrophy and cognitive measures.Methods: We used voxel-based morphometry (VBM) to investigate gray matter (GM) loss in DLB (n = 35; mean age = 78.4; MMSE = 20.3), AD (n = 36; mean age = 78.3; MMSE = 19.5) and similar aged controls (n = 35; mean age = 76.7; MMSE = 29.1). T1 weighted MRI scans were acquired at 3 Tesla from all subjects and analyzed using VBM-DARTEL in SPM8. Cognitive function was assessed using the Cambridge Cognitive Examination (CAMCOG).Results: We found reduced gray matter in temporal, parietal, occipital, and subcortical structures in DLB when compared to normal controls. The degree of atrophy was less than that observed in AD. There was significantly more medial temporal lobe atrophy in the AD group when compared with DLB. We did not find a correlation between total CAMCOG score and atrophy, but the CAMCOG memory subscale score correlated with temporal lobe atrophy in both the DLB and combined DLB/AD group.Conclusions: DLB is associated with less gray matter atrophy and relative preservation of the medial temporal lobe when compared to AD. Degree of medial temporal atrophy may be a useful imaging biomarker and our results provide support for its inclusion in the revised consensus criteria for DLB.

scholarly journals Cortical Atrophy, White Matter Lesions, and Bulb Configuration in Patients with Idiopathic Olfactory Loss and Other Causes of Olfactory Loss

ORL ◽  
2021 ◽  
pp. 1-9
Author(s):  
Alexander Wieck Fjaeldstad ◽  
Therese Ovesen ◽  
Rikke Beese Dalby
Keyword(s):  
White Matter ◽  
Medial Temporal Lobe ◽  
Structural Changes ◽  
Structural Integrity ◽  
White Matter Lesions ◽  
Structural Mri ◽  
Cortical Atrophy ◽  
Mri Findings ◽  
Olfactory Loss ◽  
Post Traumatic

<b><i>Introduction:</i></b> While magnetic resonance imaging (MRI) is not included in the current guidelines for diagnosing olfactory disorders in the most recent position paper on olfactory dysfunction, both 1.5T and 3T MRI are commonly used in the diagnostic workup of many patients with olfactory loss. Often, MRI is used to rule out intracranial tumours, but other useful information may be obtained from MRI scans in these patients. The potential of MRI in olfactory loss depends on sufficient knowledge of structural changes in different aetiologies of olfactory loss. We present common clinical MRI findings in olfactory loss and evaluate the usefulness of structural integrity scores in differentiating between aetiologies. <b><i>Methods:</i></b> In this study, we investigated if white matter hyperintensities (WMHs, measured by Fazekas score), global cortical atrophy (GCA), and medial temporal lobe atrophy (MTA) are more common in patients with idiopathic olfactory loss than in patients with acquired olfactory loss due to other aetiologies. Furthermore, we compared olfactory bulb (OB) configurations in different olfactory loss aetiologies. <b><i>Results:</i></b> In 88 patients with olfactory loss, WMHs, GCA, and MTA were not more significant findings on MRI in idiopathic olfactory loss (<i>n</i> = 51) compared with other causes of acquired olfactory loss (Fazekas score <i>p</i> = 0.2977; GCA score <i>p</i> = 0.6748; MTA score <i>p</i> = 0.7851). Bulb configurations differed in patients suffering from post-traumatic olfactory loss and may aid in identifying the underlying aetiology in patients where trauma is among the suspected causes of olfactory loss. <b><i>Conclusion:</i></b> We recommend that structural MRI with an OB sequence is included in the diagnostic evaluation of olfactory loss with suspected congenital and post-traumatic aetiology and should be considered in idiopathic olfactory loss with suspected central aetiology (e.g., tumour).

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