Does attentional dysfunction and thalamic atrophy predict decline in dementia with Lewy bodies?. (December 2017)

• Record Type: Journal Article
• Authors: Watson, Rosie; Colloby, Sean J.; Blamire, Andrew M.; Wesnes, Keith A.; Wood, Josh; O'Brien, John T.
• Is Part Of: Parkinsonism & related disorders. Volume 45(2017)
• Page Start: 69
• Page End: 74
• Publication Date: 2017-12
• Subjects: Dementia -- Lewy body -- MRI -- Neuroimaging -- thalamus; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; Movement Disorders -- Periodicals; Nerve Degeneration -- Periodicals; Nervous System Diseases -- Periodicals; Parkinson Disease -- Periodicals; Tremor -- Periodicals; Parkinson, Maladie de -- Périodiques; Parkinson's disease; 616.833
• DOI: 10.1016/j.parkreldis.2017.10.006
• Languages: English
• ISSNs: 1353-8020

Abstract

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 = 26) 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. Highlights: Thalamic atrophy relate to attentional dysfunction and fluctuations in DLB. Atrophy pattern differed in patients who died within 12 months of assessment. Results characterise changes underpinning disease symptoms and heterogeneity.