, Volume 61, Issue 11, pp 1239–1249 | Cite as

Characteristic asymmetric limbic and anterior temporal atrophy in demented patients with pathologically confirmed argyrophilic grain disease

  • Keita SakuraiEmail author
  • Aya.M Tokumaru
  • Toshimasa Ikeda
  • Satoru Morimoto
  • Shohei Inui
  • Kaoru Sumida
  • Hiroshi Oba
  • Motoo Nakagawa
  • Noriyuki Matsukawa
  • Yoshio Hashizume
Diagnostic Neuroradiology



The purpose of this study is to clarify the characteristic structural magnetic resonance imaging (MRI) findings in demented patients with pathologically confirmed argyrophilic grain disease (AGD).


Nine pathologically confirmed AGD patients with cerebral three-dimensional T1-weighted MRI were evaluated in this study. In addition to visual rating scales of atrophic and asymmetric changes in the limbic and temporal lobes, voxel-based morphometry (VBM) was performed to assess group difference between pathologically confirmed AGD and Alzheimer’s disease (AD) patients.


On visual analyses of AGD patients, the medial temporal, anterior temporal, and posterior temporal atrophy scores were 3.3 ± 0.7, 1.7 ± 0.5, and 1.0 ± 0.7, respectively. Asymmetric scores of the hippocampus and parahippocampal gyrus, amygdala and ambient gyrus, anterior temporal, and posterior temporal lobes were rated as 1.1 ± 0.7, 1.6 ± 0.5, 1.3 ± 0.8, and 0.4 ± 0.7, respectively. In spite of no statistical differences in atrophic scores, AGD patients showed the higher score and proportion of anterior temporal asymmetric score than AD (p = 0.03 and 0.02). Compared with controls, VBM analysis revealed left dominant asymmetric atrophy predominantly in the limbic and anterior temporal lobe in AGD patients. By contrast, there was no significant gray matter reduction between AGD and AD patients.


Asymmetric atrophy relatively localized to the anterior temporal and limbic lobes including the amygdala and ambient gyrus is a characteristic MRI finding of AGD. For the precise antemortem diagnosis, especially to differentiation from AD, it is important to pay attention to this asymmetric change.


Argyrophilic grain disease Asymmetric atrophy Magnetic resonance imaging Visual rating scale Voxel-based morphometry 


Author contributions

1.Guarantor of integrity of the entire study: Keita Sakurai, Aya.M Tokumaru

2. Study concepts: Keita Sakurai

3. Study design: Keita Sakurai, Toshimasa Ikeda

4. Definition of intellectual content: Not applicable

5. Literature research: Keita Sakurai, Satoru Morimoto, Motoo Nakagawa

6. Clinical studies: Toshimasa Ikeda, Satoru Morimoto, Noriyuki Matsukawa, Yoshio Hashizume

7. Experimental studies: Not applicable

8. Data acquisition: Shohei Inui, Kaoru Sumida, Yoshio Hashizume

9. Data analysis: Keita Sakurai, Aya.M Tokumaru, Motoo Nakagawa

10. Statistical analysis: Keita Sakurai

11. Manuscript preparation: Keita Sakurai

12. Manuscript editing: Hiroshi Oba

13. Manuscript review: Hiroshi Oba, Aya.M Tokumaru


This study was supported by Grants-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, Sports, Science and Technology (Kakenhi Wakate B, 16K19839: KS).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

We declare that all human and animal studies have been approved by the Ethics Committee for Clinical Research of the Fukushimura Hospital and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent by the bereaved of all patients was obtained from all the individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Keita Sakurai
    • 1
    Email author
  • Aya.M Tokumaru
    • 2
  • Toshimasa Ikeda
    • 3
  • Satoru Morimoto
    • 4
  • Shohei Inui
    • 1
    • 5
  • Kaoru Sumida
    • 1
  • Hiroshi Oba
    • 1
  • Motoo Nakagawa
    • 6
  • Noriyuki Matsukawa
    • 3
  • Yoshio Hashizume
    • 7
  1. 1.Department of RadiologyTeikyo University School of MedicineTokyoJapan
  2. 2.Department of Diagnostic RadiologyTokyo Metropolitan Medical center of GerontologyTokyoJapan
  3. 3.Department of Neurology and NeuroscienceNagoya City University Graduate School of Medical SciencesNagoyaJapan
  4. 4.Department of Physiology, School of MedicineKeio UniversityTokyoJapan
  5. 5.Department of Radiology, Graduate School of MedicineThe University of TokyoTokyoJapan
  6. 6.Department of RadiologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
  7. 7.Fukushimura HospitalChoju Medical InstituteTokyoJapan

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