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Manual and automated analysis of atrophy patterns in dementia with Lewy bodies on MRI

BACKGROUND: Dementia with Lewy bodies (DLB) is the second most common dementia type in patients older than 65 years. Its atrophy patterns remain unknown. Its similarities to Parkinson's disease and differences from Alzheimer's disease are subjects of current research. METHODS: The aim of o...

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Autores principales: Khadhraoui, Eya, Müller, Sebastian Johannes, Hansen, Niels, Riedel, Christian Heiner, Langer, Philip, Timäeus, Charles, Wiltfang, Jens, Bouter, Caroline, Lange, Claudia, Ernst, Marielle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943955/
https://www.ncbi.nlm.nih.gov/pubmed/35331168
http://dx.doi.org/10.1186/s12883-022-02642-0
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author Khadhraoui, Eya
Müller, Sebastian Johannes
Hansen, Niels
Riedel, Christian Heiner
Langer, Philip
Timäeus, Charles
Wiltfang, Jens
Bouter, Caroline
Lange, Claudia
Ernst, Marielle
author_facet Khadhraoui, Eya
Müller, Sebastian Johannes
Hansen, Niels
Riedel, Christian Heiner
Langer, Philip
Timäeus, Charles
Wiltfang, Jens
Bouter, Caroline
Lange, Claudia
Ernst, Marielle
author_sort Khadhraoui, Eya
collection PubMed
description BACKGROUND: Dementia with Lewy bodies (DLB) is the second most common dementia type in patients older than 65 years. Its atrophy patterns remain unknown. Its similarities to Parkinson's disease and differences from Alzheimer's disease are subjects of current research. METHODS: The aim of our study was (i) to form a group of patients with DLB (and a control group) and create a 3D MRI data set (ii) to volumetrically analyze the entire brain in these groups, (iii) to evaluate visual and manual metric measurements of the innominate substance for real-time diagnosis, and (iv) to compare our groups and results with the latest literature. We identified 102 patients with diagnosed DLB in our psychiatric and neurophysiological archives. After exclusion, 63 patients with valid 3D data sets remained. We compared them with a control group of 25 patients of equal age and sex distribution. We evaluated the atrophy patterns in both (1) manually and (2) via Fast Surfers segmentation and volumetric calculations. Subgroup analyses were done of the CSF data and quality of 3D T1 data sets. RESULTS: Concordant with the literature, we detected moderate, symmetric atrophy of the hippocampus, entorhinal cortex and amygdala, as well as asymmetric atrophy of the right parahippocampal gyrus in DLB. The caudate nucleus was unaffected in patients with DLB, while all the other measured territories were slightly too moderately atrophied. The area under the curve analysis of the left hippocampus volume ratio (< 3646mm(3)) revealed optimal 76% sensitivity and 100% specificity (followed by the right hippocampus and left amygdala). The substantia innominata’s visual score attained a 51% optimal sensitivity and 84% specificity, and the measured distance 51% optimal sensitivity and 68% specificity in differentiating DLB from our control group. CONCLUSIONS: In contrast to other studies, we observed a caudate nucleus sparing atrophy of the whole brain in patients with DLB. As the caudate nucleus is known to be the last survivor in dopamine-uptake, this could be the result of an overstimulation or compensation mechanism deserving further investigation. Its relative hypertrophy compared to all other brain regions could enable an imaging based identification of patients with DLB via automated segmentation and combined volumetric analysis of the hippocampus and amygdala. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-022-02642-0.
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spelling pubmed-89439552022-03-25 Manual and automated analysis of atrophy patterns in dementia with Lewy bodies on MRI Khadhraoui, Eya Müller, Sebastian Johannes Hansen, Niels Riedel, Christian Heiner Langer, Philip Timäeus, Charles Wiltfang, Jens Bouter, Caroline Lange, Claudia Ernst, Marielle BMC Neurol Research BACKGROUND: Dementia with Lewy bodies (DLB) is the second most common dementia type in patients older than 65 years. Its atrophy patterns remain unknown. Its similarities to Parkinson's disease and differences from Alzheimer's disease are subjects of current research. METHODS: The aim of our study was (i) to form a group of patients with DLB (and a control group) and create a 3D MRI data set (ii) to volumetrically analyze the entire brain in these groups, (iii) to evaluate visual and manual metric measurements of the innominate substance for real-time diagnosis, and (iv) to compare our groups and results with the latest literature. We identified 102 patients with diagnosed DLB in our psychiatric and neurophysiological archives. After exclusion, 63 patients with valid 3D data sets remained. We compared them with a control group of 25 patients of equal age and sex distribution. We evaluated the atrophy patterns in both (1) manually and (2) via Fast Surfers segmentation and volumetric calculations. Subgroup analyses were done of the CSF data and quality of 3D T1 data sets. RESULTS: Concordant with the literature, we detected moderate, symmetric atrophy of the hippocampus, entorhinal cortex and amygdala, as well as asymmetric atrophy of the right parahippocampal gyrus in DLB. The caudate nucleus was unaffected in patients with DLB, while all the other measured territories were slightly too moderately atrophied. The area under the curve analysis of the left hippocampus volume ratio (< 3646mm(3)) revealed optimal 76% sensitivity and 100% specificity (followed by the right hippocampus and left amygdala). The substantia innominata’s visual score attained a 51% optimal sensitivity and 84% specificity, and the measured distance 51% optimal sensitivity and 68% specificity in differentiating DLB from our control group. CONCLUSIONS: In contrast to other studies, we observed a caudate nucleus sparing atrophy of the whole brain in patients with DLB. As the caudate nucleus is known to be the last survivor in dopamine-uptake, this could be the result of an overstimulation or compensation mechanism deserving further investigation. Its relative hypertrophy compared to all other brain regions could enable an imaging based identification of patients with DLB via automated segmentation and combined volumetric analysis of the hippocampus and amygdala. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-022-02642-0. BioMed Central 2022-03-24 /pmc/articles/PMC8943955/ /pubmed/35331168 http://dx.doi.org/10.1186/s12883-022-02642-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Khadhraoui, Eya
Müller, Sebastian Johannes
Hansen, Niels
Riedel, Christian Heiner
Langer, Philip
Timäeus, Charles
Wiltfang, Jens
Bouter, Caroline
Lange, Claudia
Ernst, Marielle
Manual and automated analysis of atrophy patterns in dementia with Lewy bodies on MRI
title Manual and automated analysis of atrophy patterns in dementia with Lewy bodies on MRI
title_full Manual and automated analysis of atrophy patterns in dementia with Lewy bodies on MRI
title_fullStr Manual and automated analysis of atrophy patterns in dementia with Lewy bodies on MRI
title_full_unstemmed Manual and automated analysis of atrophy patterns in dementia with Lewy bodies on MRI
title_short Manual and automated analysis of atrophy patterns in dementia with Lewy bodies on MRI
title_sort manual and automated analysis of atrophy patterns in dementia with lewy bodies on mri
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943955/
https://www.ncbi.nlm.nih.gov/pubmed/35331168
http://dx.doi.org/10.1186/s12883-022-02642-0
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