Articles
Rates of global and regional
cerebral atrophy in AD and
frontotemporal dementia
D. Chan, PhD, MRCP; N.C. Fox, MD, MRCP; R. Jenkins, BSc; R.I. Scahill, MSc; W.R. Crum, DPhil;
and M.N. Rossor, MD, FRCP
Article abstract—Objective: Serial registered MRI provides a reproducible technique for detecting progressive cerebral
atrophy in vivo and was used to determine if there were differences between the rates of cerebral atrophy in AD and
frontotemporal dementia (FTD). Methods: Eighty-four patients with dementia (54 AD and 30 FTD) and 27 age-matched
control subjects each had at least two volumetric MR scans. Serial scans were positionally matched (registered), and brain
volume loss was determined by calculation of the brain boundary shift integral. Results: There was a difference between
the rates of whole-brain atrophy in patients (mean annual volume loss 2.7% of total brain volume) and in control subjects
(mean annual volume loss 0.5%). AD and FTD were associated with different rates of atrophy (mean annual losses 2.4 and
3.2%). The range of atrophy rates in the FTD group (0.3 to 8.0%) greatly exceeded that in the AD group (0.5 to 4.7%).
Frontal-variant FTD was associated with a wider range of atrophy rates than temporal-variant FTD. Analysis of regional
brain atrophy rates revealed that there was widespread symmetrically distributed cerebral volume loss in AD, whereas in
frontal FTD there was greater atrophy anteriorly and in temporal FTD the atrophy rate was greatest in the left anterior
cerebral cortex. Conclusions: Both AD and FTD patients had increased rates of brain atrophy. Whereas the patients with
AD were associated with a relatively restricted spread of atrophy rates, the greater spread of rates observed in the
patients with FTD may reflect the heterogeneity of disease in FTD, with differences observed between frontal and
temporal FTD. Increased rates of whole-brain atrophy did not discriminate AD from FTD, but analysis of regional atrophy
rates revealed marked differences between patient groups.
NEU