Gray matter atrophy in dementia with Lewy bodies with and without concomitant Alzheimer's disease pathology

Neurobiol Aging. 2018 Nov;71:171-178. doi: 10.1016/j.neurobiolaging.2018.07.005. Epub 2018 Jul 17.


We aimed to study if patients with dementia with Lewy bodies (DLB) who have concomitant Alzheimer's disease (AD) pathology (detected antemortem by cerebrospinal fluid [CSF] biomarkers) have additional loss of gray matter volume. Ninety-eight DLB patients were divided into a "pure DLB" (DLB/AD-, n = 62) and a "mixed DLB" group (DLB/AD+, n = 36) and matched for age and symptom duration to 84 AD patients and 75 controls. We compared visual atrophy ratings, and in a subset, we analyzed cortical thickness and subcortical gray matter volumes. DLB/AD+ patients had more pronounced medial temporal lobe atrophy (MTA) compared to DLB/AD- (mean [total] MTA score 2.5 vs. 1.3, p = 0.02). Global and parietal atrophy scores were comparable between the 3 dementia groups and differed from controls. MTA score was associated with CSF Aβ-42, while posterior cortical and global atrophy scores were associated with CSF tau. Cortical thinning was found in DLB/AD-, DLB/AD+, and AD compared to controls. Concomitant AD pathology seems to cause additional (hippocampal) atrophy in DLB, and this may contribute to a more devastating disease course in DLB/AD+ patients.

Keywords: Alzheimer's disease; Atrophy; Dementia with Lewy bodies; MRI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alzheimer Disease / cerebrospinal fluid
  • Alzheimer Disease / complications
  • Alzheimer Disease / diagnostic imaging
  • Alzheimer Disease / pathology*
  • Atrophy
  • Biomarkers / cerebrospinal fluid
  • Brain / diagnostic imaging
  • Brain / pathology*
  • Female
  • Gray Matter / diagnostic imaging
  • Gray Matter / pathology*
  • Humans
  • Lewy Body Disease / cerebrospinal fluid
  • Lewy Body Disease / complications
  • Lewy Body Disease / diagnostic imaging
  • Lewy Body Disease / pathology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged


  • Biomarkers