Brain Advance Access originally published online on April 7, 2005
Brain 2005 128(7):1595-1604; doi:10.1093/brain/awh493
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Brain tissue damage in dementia with Lewy bodies: an in vivo diffusion tensor MRI study
1 Don Carlo Gnocchi Foundation, Scientific Institute and University, IRCCS, 2 Department of Neuroradiology, Scientific Institute and University Ospedale San Raffaele, Milan, Italy and 3 Institute of Cognitive Neuroscience and 4 NMR Research Unit, Institute of Neurology, University College London, London, UK
Correspondence to: Dr Marco Bozzali, Wellcome Department of Imaging Neuroscience, Institute of Neurology, University College London, 12 Queen Square, London WC1N 3BG, UK E-mail: m.bozzali{at}fil.ion.ucl.ac.uk
The aim of the present study was to apply diffusion tensor MRI (DT-MRI), a quantitative MRI measure which reflects tissue organization, to dementia with Lewy bodies (DLB). DT-MRI scans were obtained from 15 patients with probable DLB and 10 sex- and age-matched healthy controls. Abnormalities were found in the corpus callosum, pericallosal areas and the frontal, parietal, occipital and, less prominently, temporal white matter of patients compared with controls. Abnormalities were also found in the caudate nucleus and the putamen. The average grey matter volume was lower in patients than in controls. These findings of concomitant grey matter atrophy and white matter abnormalities (as detected by DT-MRI) in regions with a high prevalence of long connecting fibre tracts might suggest the presence of neurodegeneration involving associative cortices. The modest involvement of the temporal lobe fits with the relative preservation of global neuropsychological measures and memory tasks in the early stage of DLB. The selective involvement of parietal, frontal and occipital lobes might explain some of the clinical and neuropsychological features of DLB, providing a possible distinctive marker for this disease. The abnormalities found in the subcortical grey matter may indicate that DLB and Parkinson's disease share a similar nigrostriatal involvement caused by common pathophysiological mechanisms.
Key Words: dementia; diffusion tensor; Lewy body; MRI; neuropsychological
Abbreviations:
= mean diffusivity; DLB = dementia with Lewy bodies; DT-MRI = diffusion tensor magnetic resonance imaging; DWMHs = deep white matter hyperintensitivites; EPI = echo-planar imaging; FA = fractional anisotropy; MMSE = Mini-Mental State Examination; MPRAGE = magnetization-prepared rapid-acquisition gradient echo; PGSE = pulsed gradient spin-echo; PVH = periventricular hyperintensity; ROI = region of interest; SPECT = single photon emission computed tomography; TE = echo time; TI = inversion time; TR = repetition time; TSE = turbo spin-echo; VOSP = Visual Object Space and Perception
Received October 5, 2004. Revised March 1, 2005. Accepted March 2, 2005.
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