A signature pattern of cortical atrophy in dementia with Lewy bodies: A study on 333 patients from the European DLB consortium

Alzheimers Dement. 2019 Mar;15(3):400-409. doi: 10.1016/j.jalz.2018.09.011. Epub 2018 Nov 12.


Introduction: We explored regional brain atrophy patterns and their clinical correlates in dementia with Lewy bodies (DLB).

Methods: In this multicentre study, we included a total of 333 patients with DLB, 352 patients with Alzheimer's disease (AD), and 233 normal controls and used medial temporal lobe atrophy, posterior atrophy, and frontal atrophy (GCA-F) visual rating scales. Patients were classified according to four atrophy patterns.

Results: Patients with DLB had higher scores on all the three atrophy scales than normal controls but had less medial temporal lobe atrophy than those with AD (all P values < .001). A signature hippocampal-sparing pattern of regional atrophy was observed in DLB. The magnetic resonance imaging measures showed 65% ability to discriminate between DLB and AD and marginally contributed to the discrimination over and above the core clinical features.

Discussion: The most common pattern of atrophy of DLB was hippocampal-sparing. Future studies should explore whether comorbid AD pathology underlies the atrophy patterns seen in DLB.

Keywords: Alzheimer's disease; Dementia; Dementia with Lewy bodies; Differential diagnosis; Hippocampal spearing atrophy pattern; Limbic-predominant atrophy pattern; Magnetic resonance imaging; Medial temporal atrophy; Minimal-atrophy pattern; Neuroimaging; Posterior atrophy frontal atrophy; Typical Alzheimer's disease atrophy pattern.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Alzheimer Disease / diagnostic imaging
  • Alzheimer Disease / pathology
  • Atrophy
  • Cerebral Cortex / diagnostic imaging*
  • Cerebral Cortex / pathology
  • Diagnosis, Differential
  • Europe
  • Female
  • Humans
  • Lewy Body Disease / diagnostic imaging*
  • Lewy Body Disease / pathology
  • Magnetic Resonance Imaging
  • Male
  • Mental Status and Dementia Tests
  • Retrospective Studies