Volumetric study of lobar atrophy in Pick complex and Alzheimer's disease.
BACKGROUND
Lobar atrophy is an important neuroimaging feature of Pick complex (PiC). However, differences in patterns of focal brain atrophy between PiC and Alzheimer's disease (AD), and among PiC subgroups, have not been studied quantitatively.


OBJECTIVE
To compare volumetric measures among primary progressive aphasia (PPA), frontotemporal dementia (FTD) and AD; to assess association between brain atrophy and cognition.


METHODS
Seventeen patients with PPA, 11 with FTD and 24 with probable AD were studied.


METHODS
We measured total and regional volume quantitatively using MRI and computerized volumetry. Contributing factors were controlled statistically or by adopting brain volume ratios. We investigated the classifying power of volumetry and correlated regional brain volume with cognitive and language test scores.


RESULTS
The ratio for fronto-temporo-central region was smaller on the left in PPA and on the right in FTD. AD and some PPA patients had smaller parietal lobes. The frontal ratios correctly classified 93% of PPA and FTD patients, but only 50% of the entire PiC and AD patients. Language-dependent examinations correlated with the left fronto-temporal volume.


CONCLUSIONS
Brain atrophy differs in PPA, FTD and AD, but there is some morphological overlap between PiC and AD in parietal volumes. Focal brain atrophy is most consistently associated with language impairments.
Fukui
T
T
Department of Neurological Sciences, St. Joseph's Health Centre, University of Western Ontario, 268 Grosvenor St., London, Canada.
Kertesz
A
A
D000368:Aged; D000544:Alzheimer Disease / Q000473:pathology*; D018888:Aphasia, Primary Progressive / Q000473:pathology*; D001284:Atrophy; D002540:Cerebral Cortex / Q000473:pathology*; D003071:Cognition; D003704:Dementia / Q000473:pathology; D004292:Dominance, Cerebral; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D007361:Intelligence Tests; D007807:Language Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000473:pathology; D008875:Middle Aged; D009483:Neuropsychological Tests; D015588:Observer Variation; D010296:Parietal Lobe / Q000473:pathology; D020774:Pick Disease of the Brain / Q000145:classification / Q000473:pathology*; D015203:Reproducibility of Results; D013702:Temporal Lobe / Q000473:pathology