OBJECTIVES: To investigate the diagnostic accuracy of visual inspection of magnetic resonance imaging (MRI) in a range of pathologically confirmed diseases causing young-onset dementia and to assess the sensitivity and specificity of atrophy patterns for Alzheimer disease (AD) and frontotemporal lobar degeneration (FTLD). DESIGN: Sixty-two patients with pathologically confirmed diseases that may present as young-onset dementia were selected from a biopsy and postmortem series. The first diagnostic T1-weighted volumetric MRI was obtained for each patient, together with images from 22 healthy control subjects. All MRIs were assessed for regional atrophy independently by 3 neuroradiologists, blinded to all clinical details except age. Observers were also asked to use their clinical judgment to form a diagnosis. RESULTS: Eighty-seven percent of dementia cases were distinguished from controls after visual inspection of MRI, and a correct pathologically confirmed diagnosis was given in 58% of cases. Hippocampal atrophy was noted in 92% of AD cases but was commonly seen in other dementias and controls. A bilateral symmetrical pattern of hippocampal atrophy discriminated AD from FTLD with 47% specificity, while posterior greater than anterior gradient of atrophy was 92% specific for AD. Atrophy of the anterior, inferior, and lateral temporal lobes was suggestive of FTLD pathology (> or =90% sensitivity), while anterior greater than posterior gradient of atrophy and hemispheric asymmetry of atrophy were each at least 85% specific for FTLD. CONCLUSION: Despite variation and overlap of atrophy patterns, visual inspection of regional atrophy on MRI may aid in discriminating AD and FTLD.
OBJECTIVES: To investigate the diagnostic accuracy of visual inspection of magnetic resonance imaging (MRI) in a range of pathologically confirmed diseases causing young-onset dementia and to assess the sensitivity and specificity of atrophy patterns for Alzheimer disease (AD) and frontotemporal lobar degeneration (FTLD). DESIGN: Sixty-two patients with pathologically confirmed diseases that may present as young-onset dementia were selected from a biopsy and postmortem series. The first diagnostic T1-weighted volumetric MRI was obtained for each patient, together with images from 22 healthy control subjects. All MRIs were assessed for regional atrophy independently by 3 neuroradiologists, blinded to all clinical details except age. Observers were also asked to use their clinical judgment to form a diagnosis. RESULTS: Eighty-seven percent of dementia cases were distinguished from controls after visual inspection of MRI, and a correct pathologically confirmed diagnosis was given in 58% of cases. Hippocampal atrophy was noted in 92% of AD cases but was commonly seen in other dementias and controls. A bilateral symmetrical pattern of hippocampal atrophy discriminated AD from FTLD with 47% specificity, while posterior greater than anterior gradient of atrophy was 92% specific for AD. Atrophy of the anterior, inferior, and lateral temporal lobes was suggestive of FTLD pathology (> or =90% sensitivity), while anterior greater than posterior gradient of atrophy and hemispheric asymmetry of atrophy were each at least 85% specific for FTLD. CONCLUSION: Despite variation and overlap of atrophy patterns, visual inspection of regional atrophy on MRI may aid in discriminating AD and FTLD.
Authors: T W Chow; F Gao; K A Links; J E Ween; D F Tang-Wai; J Ramirez; C J M Scott; M Freedman; D T Stuss; S E Black Journal: Dement Geriatr Cogn Disord Date: 2011-05-31 Impact factor: 2.959
Authors: Giovanni B Frisoni; Nick C Fox; Clifford R Jack; Philip Scheltens; Paul M Thompson Journal: Nat Rev Neurol Date: 2010-02 Impact factor: 42.937
Authors: April M Huseby Kelcher; Pascal A Atanga; Jeffrey D Gamez; Luz M Cumba Garcia; Stephanie J Teclaw; Kevin D Pavelko; Slobodan I Macura; Aaron J Johnson Journal: FASEB J Date: 2017-02-10 Impact factor: 5.191
Authors: G D Rabinovici; W W Seeley; E J Kim; M L Gorno-Tempini; K Rascovsky; T A Pagliaro; S C Allison; C Halabi; J H Kramer; J K Johnson; M W Weiner; M S Forman; J Q Trojanowski; S J Dearmond; B L Miller; H J Rosen Journal: Am J Alzheimers Dis Other Demen Date: 2007 Dec-2008 Jan Impact factor: 2.035