Detailed volumetric analysis of the hypothalamus in behavioral variant frontotemporal dementia.
Abnormal eating behaviors are frequently reported in behavioral variant frontotemporal dementia (bvFTD). The hypothalamus is the regulatory center for feeding and satiety but its involvement in bvFTD has not been fully clarified, partly due to its difficult identification on MR images. We measured hypothalamic volume in 18 patients with bvFTD (including 9 MAPT and 6 C9orf72 mutation carriers) and 18 cognitively normal controls using a novel optimized multimodal segmentation protocol, combining 3D T1 and T2-weighted 3T MRIs (intrarater intraclass correlation coefficients ≥0.93). The whole hypothalamus was subsequently segmented into five subunits: the anterior (superior and inferior), tuberal (superior and inferior), and posterior regions. The presence of abnormal eating behavior was assessed with the revised version of the Cambridge Behavioural Inventory (CBI-R). The bvFTD group showed a 17% lower hypothalamic volume compared with controls (p < 0.001): mean 783 (standard deviation 113) versus 944 (73) mm(3) (corrected for total intracranial volume). In the hypothalamic subunit analysis, the superior parts of the anterior and tuberal regions and the posterior region were significantly smaller in the bvFTD group compared with controls. There was a trend for a smaller hypothalamic volume, particularly in the superior tuberal region, in those with severe eating disturbance scores on the CBI-R. Differences were seen between the two genetic subgroups with significantly smaller volumes in the MAPT but not the C9orf72 group compared with controls. In summary, bvFTD patients had lower hypothalamic volumes compared with controls. Different genetic mutations may have a differential impact on the hypothalamus.
Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK.|Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.|Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
Martina
M
Bocchetta
Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK.
Elizabeth
E
Gordon
Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK.
Emily
E
Manning
Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK.
Josephine
J
Barnes
Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK.
David M
DM
Cash
Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK.|Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK.
Miklos
M
Espak
Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK.
David L
DL
Thomas
Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK.|Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK.
Marc
M
Modat
Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK.
Martin N
MN
Rossor
Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK.
Jason D
JD
Warren
Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK.|Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK.
Sebastien
S
Ourselin
Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.|Memory Clinic and Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland.
Giovanni B
GB
Frisoni
Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK. j.rohrer@ucl.ac.uk.
Jonathan D
JD
Rohrer
D000328:Adult; D000368:Aged; D001068:Feeding and Eating Disorders / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D057180:Frontotemporal Dementia / Q000150:complications / Q000235:genetics / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D007031:Hypothalamus / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged
Eating disorders; Frontotemporal dementia; Hypothalamus; Volumetric MRI