White matter damage in frontotemporal dementia and Alzheimer's disease measured by diffusion MRI
Open accessAbstract
Frontotemporal dementia (FTD) and Alzheimer's disease are sometimes difficult to differentiate clinically because of overlapping symptoms. Using diffusion tensor imaging (DTI) measurements of fractional anisotropy (FA) can be useful in distinguishing the different patterns of white matter degradation between the two dementias. In this study, we performed MRI scans in a 4 Tesla MRI machine including T1-weighted structural images and diffusion tensor images in 18 patients with FTD, 18 patients with Alzheimer's disease and 19 cognitively normal (CN) controls. FA was measured selectively in specific fibre tracts (including corpus callosum, cingulum, uncinate and corticospinal tracts) as well as globally in a voxel-by-voxel analysis. Patients with FTD were associated with reductions of FA in frontal and temporal regions including the anterior corpus callosum (P < 0.001), bilateral anterior (left P < 0.001; right P = 0.005), descending (left P < 0.001; right P = 0.003) cingulum tracts, and uncinate tracts (left P < 0.001; right P = 0.005), compared to controls. Patients with Alzheimer's disease were associated with reductions of FA in parietal, temporal and frontal regions including the left anterior (P = 0.003) and posterior (P = 0.002) cingulum tracts, bilateral descending cingulum tracts (P < 0.001) and left uncinate tracts (P < 0.001) compared to controls. When compared with Alzheimer's disease, FTD was associated with greater reductions of FA in frontal brain regions, whereas no region in Alzheimer's disease showed greater reductions of FA when compared to FTD. In conclusion, the regional patterns of anisotropy reduction in FTD and Alzheimer's disease compared to controls suggest a characteristic distribution of white matter degradation in each disease. Moreover, the white matter degradation seems to be more prominent in FTD than in Alzheimer's disease. Taken together, the results suggest that white matter degradation measured with DTI may improve the diagnostic differentiation between FTD and Alzheimer's disease.
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DTI shows sensitivity to axon and myelin pathology, where breakdown of white matter integrity results in measurable differences in diffusion of water molecules.
“DTI shows sensitivity to axon and myelin pathology, where breakdown of white matter integrity results in measurable differences in diffusion of water molecules [15,16].”
From Diffusion tensor imaging reveals whole-brain microstructural changes in the P301L mouse model of tauopathy. (2020) · cites this paper as [16]
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- Authors
- Zhang, Y., Schuff, N., Du, A.-T., Rosen, H. J., Kramer, J. H., Gorno-Tempini, M. L., Miller, B. L., & Weiner, M. W.
- Affiliations
- San Francisco VA Medical Center (US)
- University of California, San Francisco (US)
- Corresponding author
- Zhang, Y.
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-05-12
- Volume
- 132
- Issue
- 9
- Pages
- 2579-2592
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- PMC
- PMC2732263
- OpenAlex
- W2160917765
- Cited by
- 356
- References
- 4
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 13 · 2023: 13 · 2022: 16 · 2021: 16 · 2020: 16 · 2019: 24 · 2018: 23 · 2017: 21 · 2016: 24 · 2015: 22 · 2014: 30 · 2013: 32 · 2012: 28
- FWCI
- 16.70
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Brain (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Institutional Research Information System (Università degli Studi di Trento) (submittedVersion, cc-by-nc)
- Funders
- U.S. Department of Defense (DAMD170310532)
- U.S. Department of Veterans Affairs
- National Institutes of Health
- National Institute on Aging (P50-AG23501, P01-AG19724, P01AG019724, P50AG023501)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- frontotemporal dementia, Alzheimer's disease, white matter injury, fractional anisotropy, diffusion tensor imaging, corpus callosum, uncinate fasciculus, corticospinal tract, differential diagnosis of dementia
- MeSH terms
- Adult, Aged, Alzheimer Disease, Cross-Sectional Studies, Dementia, Diagnosis, Differential, Female, Frontal Lobe, Humans, Image Interpretation, Computer-Assisted, Male, Middle Aged, Temporal Lobe, Diffusion Magnetic Resonance Imaging
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