Department of Radiology, Mayo Clinic Rochester, Rochester, MN, USA.
J Mol Neurosci. 2011 Nov;45(3):372-8. doi: 10.1007/s12031-011-9533-3. Epub 2011 May 10.
Pathology underlying behavioral variant frontotemporal dementia (bvFTD) is heterogeneous, with the most common pathologies being Pick's disease (PiD), corticobasal degeneration (CBD), and FTLD-TDP type 1. Clinical features are unhelpful in differentiating these pathologies. We aimed to determine whether imaging atrophy patterns differ across these pathologies in bvFTD subjects. We identified 15 bvFTD subjects that had volumetric MRI during life and autopsy: five with PiD, five CBD, and five FTLD-TDP type 1. Voxel-based morphometry was used to assess atrophy patterns in each bvFTD group compared to 20 age- and gender-matched controls. All three pathological groups showed gray matter loss in frontal lobes, although specific patterns of atrophy differed across groups: PiD showed widespread loss in frontal lobes with additional involvement of anterior temporal lobes; CBD showed subtle patterns of loss involving posterior lateral and medial superior frontal lobe; and FTLD-TDP type 1 showed widespread loss in frontal, temporal, and parietal lobes. Greater parietal loss was observed in FTLD-TDP type 1 compared to both other groups, and greater anterior temporal and medial frontal loss was observed in PiD compared to CBD. Imaging patterns of atrophy in bvFTD vary according to pathological diagnosis and may therefore be helpful in predicting these pathologies in bvFTD.
行为变异额颞叶痴呆（bvFTD）的病理学基础具有异质性，最常见的病理学改变包括 Pick 病（PiD）、皮质基底节变性（CBD）和 FTLD-TDP 型 1。临床特征无助于区分这些病理学改变。我们旨在确定在 bvFTD 患者中，这些病理学改变的影像学萎缩模式是否存在差异。我们确定了 15 名在生前进行过容积 MRI 检查且有尸检结果的 bvFTD 患者：5 名 PiD、5 名 CBD 和 5 名 FTLD-TDP 型 1。我们使用基于体素的形态测量学方法来评估每个 bvFTD 组与 20 名年龄和性别匹配的对照组之间的萎缩模式。所有三组病理学改变患者的额叶都出现灰质丢失，尽管萎缩模式存在差异：PiD 患者表现为额叶广泛丢失，伴有前颞叶额外受累；CBD 患者表现为涉及后外侧和内侧额上回的细微丢失模式；FTLD-TDP 型 1 患者则表现为额叶、颞叶和顶叶广泛丢失。与其他两组相比，FTLD-TDP 型 1 患者的顶叶丢失更明显，与 CBD 相比，PiD 患者的前颞叶和内侧额叶丢失更明显。bvFTD 的影像学萎缩模式根据病理诊断而有所不同，因此可能有助于预测 bvFTD 的这些病理学改变。
