Does attentional dysfunction and thalamic atrophy predict decline in dementia with Lewy bodies?
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Publication Date
2017-12Journal Title
Parkinsonism & related disorders
ISSN
1353-8020
Publisher
Elsevier
Volume
45
Pages
69-74
Language
eng
Type
Article
This Version
AM
Physical Medium
Print-Electronic
Metadata
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Watson, R., Colloby, S. J., Blamire, A. M., Wesnes, K. A., Wood, J., & O'Brien, J. (2017). Does attentional dysfunction and thalamic atrophy predict decline in dementia with Lewy bodies?. Parkinsonism & related disorders, 45 69-74. https://doi.org/10.1016/j.parkreldis.2017.10.006
Abstract
Introduction
To evaluate the clinical characteristics of DLB subjects who died within 1 year of assessment compared to those who survived and investigate their patterns of in vivo regional thalamic atrophy using structural MRI.
Methods
Seventy subjects (35 DLB, 35 aged controls) underwent 3 T T1-weighted MR scanning as well as clinical and cognitive assessments, including a computerised assessment of attention. All subjects were contacted after 12 months for reassessment.
For both hemispheres, using FSL FIRST, the thalamus was automatically segmented followed by inter-subject vertex-wise analyses involving group comparisons and behavioural correlates.
Results
There was significant bilateral atrophy in the ventral-dorsal and pulvinar regions in DLB relative to controls (pcorrected < 0.05). The DLB group was then re-categorised based on 12-month mortality data: DLB-a (n = 25) and DLB-d (n = 9) (a = alive, d = death within 12 months of study assessment). Compared to controls, significant attentional dysfunction and bilateral atrophy of the pulvinar, ventral and dorsal nuclei were observed in DLB-d (pcorrected < 0.05), whereas in DLB-a, atrophy was far less extensive.
Conclusions
Distinct patterns of thalamic atrophy occur in DLB that may relate to the attentional dysfunction and cognitive fluctuations that characterise this disorder. Relative to controls, the extent of attentional impairment and pattern of thalamic degeneration differ in those patients who died within 12 months of assessment, despite having an otherwise similar level of dementia severity. These findings may provide insight into the neurobiological changes underpinning important clinical characteristics and disease heterogeneity.
Keywords
Brain, Thalamus, Humans, Lewy Body Disease, Atrophy, Magnetic Resonance Imaging, Attention, Aged, Aged, 80 and over, Female, Male, Cognitive Dysfunction
Identifiers
External DOI: https://doi.org/10.1016/j.parkreldis.2017.10.006
This record's URL: https://www.repository.cam.ac.uk/handle/1810/270858
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