Characteristic asymmetric limbic and anterior temporal atrophy in demented patients with pathologically confirmed argyrophilic grain disease
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.
KeywordsArgyrophilic grain disease Asymmetric atrophy Magnetic resonance imaging Visual rating scale Voxel-based morphometry
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.
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 by the bereaved of all patients was obtained from all the individual participants included in the study.
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