Study Finds Pronounced Atrophy in Dementia Patients With Psychiatric Onset

Published on October 5, 2022

Imagine your brain is a city, with different neighborhoods representing different regions. Researchers used metric magnetic resonance imaging (MRI) to examine the brains of patients with dementia with Lewy bodies (DLB) and found pronounced atrophy in a specific region called the substantia innominata (SI). This atrophy was particularly evident in patients who experienced a psychiatric onset of symptoms. The study used both manual measurements and automated volumetric analysis of MRI scans to assess atrophy patterns. Interestingly, no regional volumetric differences were found between groups when using the automated analysis. These findings suggest that the SI may be more severely affected in DLB patients with a psychiatric onset compared to those with mild cognitive impairment (MCI) as their initial symptom. To further investigate this potential difference and its implications for diagnosis and treatment, more research is needed with larger patient cohorts. If you’re intrigued and want to delve deeper into the study, check out the full article!

BackgroundDementia with Lewy bodies (DLB) is a type of dementia often diagnosed in older patients. Since its initial symptoms range from delirium to psychiatric and cognitive symptoms, the diagnosis is often delayed.ObjectivesIn our study, we evaluated the magnetic resonance imaging (MRI) of patients suffering from DLB in correlation with their initial symptoms taking a new pragmatic approach entailing manual measurements in addition to an automated volumetric analysis of MRI.MethodsA total of 63 patients with diagnosed DLB and valid 3D data sets were retrospectively and blinded evaluated. We assessed atrophy patterns (1) manually for the substantia innominata and (2) via FastSurfer for the most common supratentorial regions. Initial symptoms were categorized by (1) mild cognitive impairment (MCI), (2) psychiatric episodes, and (3) delirium.ResultsManual metric MRI measurements revealed moderate, but significant substantia-innominata (SI) atrophy in patients with a psychiatric onset. FastSurfer analysis revealed no regional volumetric differences between groups.ConclusionThe SI in patients with DLB and a psychiatric-onset is more atrophied than that in patients with initial MCI. Our results suggest potential differences in SI between DLB subtypes at the prodromal stage, which are useful when taking a differential-diagnostic approach. This finding should be confirmed in larger patient cohorts.

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