title: Frontotemporal atrophy associated with paranoid delusions in women with Alzheimer's disease.
abstract: BACKGROUND
  Paranoid delusions are a common and difficult-to-manage feature of Alzheimer's disease (AD). We investigated the neuroanatomical correlates of paranoid delusions in a cohort of AD patients, using magnetic resonance imaging (MRI) to measure regional volume and regional cortical thickness.
  
  
  METHODS
  113 participants with probable AD were assessed for severity of disease, cognitive and functional impairment. Presence and type of delusions were assessed using the Neuropsychiatric Inventory (NPI). Structural MRI images were acquired on a 1.5 T scanner, and were analyzed using an automated analysis pipeline.
  
  
  RESULTS
  Paranoid delusions were experienced by 23 (20.4%) of the participants. Female participants with paranoid delusions showed reduced cortical thickness in left medial orbitofrontal and left superior temporal regions, independently of cognitive decline. Male participants with delusions did not show any significant differences compared to males without delusions. An exploratory whole brain analysis of non-hypothesized regions showed reduced cortical thickness in the left insula for female participants only.
  
  
  CONCLUSIONS
  Frontotemporal atrophy is associated with paranoid delusions in females with AD. Evidence of sex differences in the neuroanatomical correlates of delusions as well as differences in regional involvement in different types of delusions may be informative in guiding management and treatment of delusions in AD.
authors: MRC Centre for Neurodegeneration Research, King's College London, Institute of Psychiatry, UK. d.whitehead@ion.ucl.ac.uk
authors: D
authors: D
authors: Whitehead
authors: C
authors: C
authors: Tunnard
authors: C
authors: C
authors: Hurt
authors: L O
authors: LO
authors: Wahlund
authors: P
authors: P
authors: Mecocci
authors: M
authors: M
authors: Tsolaki
authors: B
authors: B
authors: Vellas
authors: C
authors: C
authors: Spenger
authors: I
authors: I
authors: Kłoszewska
authors: H
authors: H
authors: Soininen
authors: D
authors: D
authors: Cromb
authors: S
authors: S
authors: Lovestone
authors: A
authors: A
authors: Simmons
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000150:complications* / Q000473:pathology; D001284:Atrophy; D003702:Delusions / Q000209:etiology* / Q000473:pathology; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D059906:Neuroimaging; D009483:Neuropsychological Tests; D010259:Paranoid Disorders / Q000209:etiology* / Q000473:pathology; D012737:Sex Factors; D013702:Temporal Lobe / Q000473:pathology*