Univ. Bordeaux, CNRS, UMR 5293, Institut des Maladies Neurodégénératives, Bordeaux, France.
Centre Mémoire Ressources Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, Bordeaux, France.
Alzheimers Dement. 2023 Aug;19(8):3283-3294. doi: 10.1002/alz.12975. Epub 2023 Feb 7.
The three clinical variants of frontotemporal dementia (behavioral variant [bvFTD], semantic dementia, and progressive non-fluent aphasia [PNFA]) are likely to develop over decades, from the preclinical stage to death.
To describe the long-term chronological anatomical progression of FTD variants, we built lifespan brain charts of normal aging and FTD variants by combining 8022 quality-controlled MRIs from multiple large-scale data-bases, including 107 bvFTD, 44 semantic dementia, and 38 PNFA.
We report in this manuscript the anatomical MRI staging schemes of the three FTD variants by describing the sequential divergence of volumetric trajectories between normal aging and FTD variants. Subcortical atrophy precedes focal cortical atrophy in specific behavioral and/or language networks, with a "radiological" prodromal phase lasting 8-10 years (time elapsed between the first structural alteration and canonical cortical atrophy).
Amygdalar and striatal atrophy can be candidate biomarkers for future preclinical/prodromal FTD variants definitions.
We describe the chronological MRI staging of the most affected structures in the three frontotemporal dementia (FTD) syndromic variants. In behavioral variant of FTD (bvFTD): bilateral amygdalar, striatal, and insular atrophy precedes fronto-temporal atrophy. In semantic dementia: bilateral amygdalar atrophy precedes left temporal and hippocampal atrophy. In progressive non-fluent aphasia (PNFA): left striatal, insular, and thalamic atrophy precedes opercular atrophy.
额颞叶痴呆（行为变异型 [bvFTD]、语义性痴呆和进行性非流利性失语症 [PNFA]）有三种临床变异型，可能会在数十年间从临床前阶段发展到死亡。
为了描述额颞叶痴呆变异型的长期时间解剖进展，我们通过结合来自多个大型数据库的 8022 份质量控制 MRI，构建了正常衰老和额颞叶痴呆变异型的终生脑图，包括 107 例 bvFTD、44 例语义性痴呆和 38 例 PNFA。
我们通过描述正常衰老和额颞叶痴呆变异型之间容积轨迹的连续发散，报告了这三种额颞叶痴呆变异型的解剖 MRI 分期方案。皮质下萎缩先于特定行为和/或语言网络中的局灶性皮质萎缩，具有“放射学”前驱期，持续 8-10 年（首次结构改变和典型皮质萎缩之间的时间间隔）。
杏仁核和纹状体萎缩可能是未来额颞叶痴呆变异型的候选生物标志物。
我们描述了三种额颞叶痴呆（FTD）综合征变异型中受影响最严重结构的时间 MRI 分期。在行为变异型 FTD（bvFTD）中：双侧杏仁核、纹状体和脑岛萎缩先于额颞叶萎缩。在语义性痴呆中：双侧杏仁核萎缩先于左侧颞叶和海马萎缩。在进行性非流利性失语症（PNFA）中：左侧纹状体、脑岛和丘脑萎缩先于脑盖部萎缩。
