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01.09.2014 | Neuro

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

verfasst von: 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

Erschienen in: European Radiology | Ausgabe 9/2014

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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

Bohnen NI, Djang DS, Herholz K, Anzai Y, Minoshima S (2012) Effectiveness and safety of 18F-FDG PET in the evaluation of dementia: a review of the recent literature. J Nucl Med 53:59–71PubMedCrossRef

McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM (1984) 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 34:939–944PubMedCrossRef

McKeith IG, Dickson DW, Lowe J et al (2005) Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology 65:1863–1872PubMedCrossRef

Neary D, Snowden JS, Gustafson L et al (1998) Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology 51:1546–1554PubMedCrossRef

Sluimer JD, van der Flier WM, Karas GB et al (2009) Accelerating regional atrophy rates in the progression from normal aging to Alzheimer’s disease. EurRadiol 19:2826–2833

Whitwell JL, Josephs KA, Rossor MN et al (2005) Magnetic resonance imaging signatures of tissue pathology in frontotemporal dementia. Arch Neurol 62:1402–1408PubMedCrossRef

Beyer MK, Larsen JP, Aarsland D (2007) Gray matter atrophy in Parkinson disease with dementia and dementia with Lewy bodies. Neurology 69:747–754PubMedCrossRef

Jack CR Jr, Knopman DS, Jagust WJ et al (2010) Hypothetical model of dynamic biomarkers of the Alzheimer’s pathological cascade. Lancet Neurol 9:119–128PubMedCentralPubMedCrossRef

Colloby SJ, Fenwick JD, Williams ED et al (2002) A comparison of (99m)Tc-HMPAO SPET changes in dementia with Lewy bodies and Alzheimer’s disease using statistical parametric mapping. Eur J Nucl Med Mol Imaging 29:615–622PubMedCrossRef

10.

Lobotesis K, Fenwick JD, Phipps A et al (2001) Occipital hypoperfusion on SPECT in dementia with Lewy bodies but not AD. Neurology 56:643–649PubMedCrossRef

11.

Mosconi L, Tsui WH, Herholz K et al (2008) Multicenter standardized 18F-FDG PET diagnosis of mild cognitive impairment, Alzheimer’s disease, and other dementias. J Nucl Med 49:390–398PubMedCentralPubMedCrossRef

12.

Dai W, Garcia D, de Bazelaire C, Alsop DC (2008) Continuous flow-driven inversion for arterial spin labeling using pulsed radio frequency and gradient fields. Magn Reson Med 60:1488–1497PubMedCentralPubMedCrossRef

13.

Binnewijzend MA, Kuijer JP, Benedictus MR et al (2013) Cerebral blood flow measured with 3D pseudocontinuous arterial spin-labeling MR imaging in Alzheimer disease and mild cognitive impairment: a marker for disease severity. Radiology 267:221–230PubMedCrossRef

14.

McKhann GM, Knopman DS, Chertkow H et al (2011) The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 7:263–269PubMedCentralPubMedCrossRef

15.

Rascovsky K, Hodges JR, Knopman D et al (2011) Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain 134:2456–2477PubMedCentralPubMedCrossRef

16.

Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA (1987) MR signal abnormalities at 1.5T in Alzheimer’s dementia and normal aging. AJR Am J Roentgenol 149:351–356PubMedCrossRef

17.

Buxton RB, Frank LR, Wong EC, Siewert B, Warach S, Edelman RR (1998) A general kinetic model for quantitative perfusion imaging with arterial spin labeling. Magn Reson Med 40:383–396PubMedCrossRef

18.

Smith SM (2002) Fast robust automated brain extraction. Hum Brain Mapp 17:143–155PubMedCrossRef

19.

Jenkinson M, Smith S (2001) A global optimisation method for robust affine registration of brain images. Med Image Anal 5:143–156PubMedCrossRef

20.

Zhang Y, Brady M, Smith S (2001) Segmentation of brain MR images through a hidden Markov random field model and the expectation-maximization algorithm. IEEE Trans Med Imaging 20:45–57PubMedCrossRef

21.

Asllani I, Borogovac A, Brown TR (2008) Regression algorithm correcting for partial volume effects in arterial spin labeling MRI. Magn Reson Med 60:1362–1371PubMedCrossRef

22.

Nichols TE, Holmes AP (2002) Nonparametric permutation tests for functional neuroimaging: a primer with examples. Hum Brain Mapp 15:1–25PubMedCrossRef

23.

Smith SM, Nichols TE (2009) Threshold-free cluster enhancement: addressing problems of smoothing, threshold dependence and localisation in cluster inference. Neuroimage 44:83–98PubMedCrossRef

24.

Alsop DC, Detre JA, Grossman M (2000) Assessment of cerebral blood flow in Alzheimer’s disease by spin-labeled magnetic resonance imaging. Ann Neurol 47:93–100PubMedCrossRef

25.

Dai W, Lopez OL, Carmichael OT, Becker JT, Kuller LH, Gach HM (2009) Mild cognitive impairment and alzheimer disease: patterns of altered cerebral blood flow at MR imaging. Radiology 250:856–866PubMedCentralPubMedCrossRef

26.

Johnson NA, Jahng GH, Weiner MW et al (2005) Pattern of cerebral hypoperfusion in Alzheimer disease and mild cognitive impairment measured with arterial spin-labeling MR imaging: initial experience. Radiology 234:851–859PubMedCentralPubMedCrossRef

27.

Kim SM, Kim MJ, Rhee HY et al (2013) Regional cerebral perfusion in patients with Alzheimer’s disease and mild cognitive impairment: effect of APOE Epsilon4 allele. Neuroradiology 55:25–34PubMedCrossRef

28.

Mak HK, Chan Q, Zhang Z et al (2012) Quantitative assessment of cerebral hemodynamic parameters by QUASAR arterial spin labeling in Alzheimer’s disease and cognitively normal elderly adults at 3-tesla. J Alzheimers Dis 31:33–44PubMed

29.

McKeith IG (2006) Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the Consortium on DLB International Workshop. J Alzheimers Dis 9:417–423PubMed

30.

Taylor JP, Firbank MJ, He J et al (2012) Visual cortex in dementia with Lewy bodies: magnetic resonance imaging study. Brit J Psychiatry 200:491–498CrossRef

31.

Fong TG, Inouye SK, Dai W, Press DZ, Alsop DC (2011) Association cortex hypoperfusion in mild dementia with Lewy bodies: a potential indicator of cholinergic dysfunction? Brain Imaging Behav 5:25–35PubMedCentralPubMedCrossRef

32.

Ishii K, Soma T, Kono AK et al (2007) Comparison of regional brain volume and glucose metabolism between patients with mild dementia with lewy bodies and those with mild Alzheimer’s disease. J Nucl Medicine 48:704–711CrossRef

33.

Shimizu S, Hanyu H, Kanetaka H, Iwamoto T, Koizumi K, Abe K (2005) Differentiation of dementia with Lewy bodies from Alzheimer’s disease using brain SPECT. Dement Geriatr Cogn Disord 20:25–30PubMedCrossRef

34.

Albin RL, Minoshima S, D’Amato CJ, Frey KA, Kuhl DA, Sima AA (1996) Fluoro-deoxyglucose positron emission tomography in diffuse Lewy body disease. Neurology 47:462–466PubMedCrossRef

35.

Sato A, Sato Y, Uchida S (2002) Regulation of cerebral cortical blood flow by the basal forebrain cholinergic fibers and aging. Auton Neurosci 96:13–19PubMedCrossRef

36.

Du AT, Jahng GH, Hayasaka S et al (2006) Hypoperfusion in frontotemporal dementia and Alzheimer disease by arterial spin labeling MRI. Neurology 67:1215–1220PubMedCentralPubMedCrossRef

37.

Hu WT, Wang Z, Lee VM, Trojanowski JQ, Detre JA, Grossman M (2010) Distinct cerebral perfusion patterns in FTLD and AD. Neurology 75:881–888PubMedCentralPubMedCrossRef

38.

Chen Y, Wolk DA, Reddin JS et al (2011) Voxel-level comparison of arterial spin-labeled perfusion MRI and FDG-PET in Alzheimer disease. Neurology 77:1977–1985PubMedCentralPubMedCrossRef

39.

Jueptner M, Weiller C (1995) Review: does measurement of regional cerebral blood flow reflect synaptic activity? Implications for PET and fMRI. NeuroImage 2:148–156PubMedCrossRef

40.

Campbell AM, Beaulieu C (2006) Pulsed arterial spin labeling parameter optimization for an elderly population. J Magn Reson Imaging 23:398–403PubMed

Titel: Distinct perfusion patterns in Alzheimer’s disease, frontotemporal dementia and dementia with Lewy bodies
verfasst von: 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
Publikationsdatum: 01.09.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 9/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3172-3

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