What is the value of brain atrophy in frontotemporal dementia?

Atrophy and frontotemporal dementia

The behavioral variant of frontotemporal dementia is a frequent cause of neurodegenerative dementia and the first cause of Frontotemporal Lobular Degeneration. Patients with the behavioral variant of frontotemporal dementia present a progressive personality change that begins years before diagnosis and can be confused with other neurodegenerative and psychiatric diseases. Identifying atrophy or loss of brain volume on MRI studies can aid in the diagnosis. However, at present the study of brain atrophy on MRI is usually based on subjective visual examinations. Recently, various methods have been validated that allow the systematic quantification of brain atrophy using brain magnetic resonance imaging.

What have we done in this study?

In this study we have determined the diagnostic and prognostic value of a group of accessible and reproducible atrophy scales in a large sample of patients with the behavioral variant of frontotemporal dementia recruited in Catalonia and the United States. These measures include various visual scales and the “Magnetic Resonance Parkinsonism Index” or MRPI.

Main results

The main finding of this work was that the visual scales made it possible to accurately differentiate patients with a behavioral variant of frontotemporal dementia from patients with other neurodegenerative and psychiatric diseases. The degree of atrophy measured using these scales made it possible to accurately estimate the rate of progression of patients during clinical follow-up. In addition, the MRPI identified patients with two specific causes of frontotemporal lobar degeneration: progressive supranuclear palsy and corticobasal degeneration at autopsy.
Atrophy - Illán-Gala - FTD - Sant Pau Memory Unit Barcelona

Relevance of the study

The quantification of cortical and subcortical atrophy is a useful resource that can be standardized using quantitative and semi-quantitative methods to improve the diagnosis of the behavioral variant of frontotemporal dementia in routine clinical practice. This study demonstrates that reproducible atrophy scales can increase the certainty of the diagnosis of frontotemporal lobar degeneration and help predict prognosis after diagnosis.

More information

Diagnostic Utility of Measuring Cerebral Atrophy in the Behavioral Variant of Frontotemporal Dementia and Association with Clinical Deterioration. Illán-Gala I, Falgàs N Friedberg A, et al., JAMA Netw Open. 2021

4 thoughts on “What is the value of brain atrophy in frontotemporal dementia?”

  1. Hola buenas noches.
    Me han hecho un T.A.C. Cerebral y el radiológo interpreta Atrofia Cortical Frontal Bilateral.
    Tengo entendido que se ve mejor con una resonancia el tipo de enfermedad que puede ser.

    Reply
    • Hola Diego, este tipo de hallazgos radiológicos siempre deben ponerse dentro de un contexto clínico adecuado, y es frecuente que por sí solos no tengan relevancia clínica. Te aconsejamos que lo comentes con tu médico.

      Reply
  2. Me hicieron un TAC en busca de un foco epiléptico y no había. En su lugar el neurólogo habla de una atrofia frontal, pero es de preocuparse o no? Solo tengo 39 años

    Reply
    • Hola Misleydi, los hallazgos radiológicos deben interpretarse en un contexto clínico, y por sí solos pueden no tener relevancia clínica. Te recomendamos que consultes directamente con tu médico acerca de la importancia de estos resultados

      Reply

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