Objective: To investigate differences in rates of progression of brain atrophy between patients with dementia with Lewy bodies (DLB), Alzheimer's disease (AD), vascular dementia (VaD) and controls.
Design: Longitudinal 1.0 Tesla MRI study. Each subject was scanned twice, at baseline and one year later.
Materials and Methods: Scans were acquired from subjects with probable DLB (n=10), mean age 73.8y), NINCDS/ADRDA probable AD (n=8, mean age 74.3y), NINCD/AIREN VaD (n=10, mean age 76.3y) and healthy controls (n=20, mean age 75.8y). The change in whole brain volume between scans was calculated for each subject by analysis of shifts in the brain/CSF boundary following brain segmentation and registration. changes in brain volume were expressed as % loss/year.
Results: Mean ±SD changes in brain volume were: DLB 1.4 ±1.1%; AD 2.2 ±0.8%; VaD 1.8 ±1.0%; controls 0.5% ±0.7%. Subjects with AD and VaD, but not DLB, had significantly increased mean atrophy rates (p<0.01) compared to controls. Subjects with DLB showed considerable overlap with the other three groups - the mean atrophy rate lying in between that of the other dementia groups and controls, though not proving significantly different from either.
Conclusion: AD and VaD, but not DLB, are characterised by significantly greater progressive brain atrophy compared to controls. This may be helpful in the diagnosis of AD and VaD, though the overlap between groups suggests this will not be the case for DLB. While serial changes in overall brain volume are similar between dementia groups, further study of regional volume changes, particularly in the temporal lobes and hippocampus, may improve discrimination.
Paling S, Barber R, Williams ED, Gholkar AI, Crum WR, Fox N, Rossor M, McKeith I, Ballard C, O'Brien JT. Measurement of progressive brain atrophy in dementia with Lewy bodies using serial MRI: a comparison with Alzheimer's disease, vascular dementia and normal ageing. International Psychogeriatric Association Conference, Newcastle upon Tyne, 4-7 April 2000.
Dr. Sean Paling, NGH Unit, Newcastle upon Tyne. Tel: +44 (0)191-233-6161.
Regional Medical Physics Department, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK.
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