Deformation based morphometry study of longitudinal MRI changes in behavioral variant frontotemporal dementia

Neuroimage Clin. 2019;24:102079. doi: 10.1016/j.nicl.2019.102079. Epub 2019 Nov 5.


Objective: To objectively quantify how cerebral volume loss could assist with clinical diagnosis and clinical trial design in the behavioural variant of frontotemporal dementia (bvFTD).

Methods: We applied deformation-based morphometric analyses with robust registration to precisely quantify the magnitude and pattern of atrophy in patients with bvFTD as compared to cognitively normal controls (CNCs), to assess the progression of atrophy over one year follow up and to generate clinical trial sample size estimates to detect differences for the structures most sensitive to change. This study included 203 subjects - 70 bvFTD and 133 CNCs - with a total of 482 timepoints from the Frontotemporal Lobar Degeneration Neuroimaging Initiative.

Results: Deformation based morphometry (DBM) revealed significant atrophy in the frontal lobes, insula, medial and anterior temporal regions bilaterally in bvFTD subjects compared to controls with outstanding subcortical involvement. We provide detailed information on regional changes per year. In both cross-sectional analysis and over a one-year follow-up period, ventricle expansion was the most prominent differentiator of bvFTD from controls and a sensitive marker of disease progression.

Conclusions: Automated measurement of ventricular expansion is a sensitive and reliable marker of disease progression in bvFTD to be used in clinical trials for potential disease modifying drugs, as well as possibly to implement in clinical practice. Ventricular expansion measured with DBM provides the lowest published estimated sample size for clinical trial design to detect significant differences over one and two years.

Keywords: Deformation based morphometry; Diagnostic biomarker; Frontotemporal dementia; Magnetic resonance imaging; Morphometric analysis.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Atrophy
  • Brain / diagnostic imaging*
  • Brain / pathology
  • Case-Control Studies
  • Cerebral Ventricles / diagnostic imaging
  • Cerebral Ventricles / pathology
  • Corpus Callosum / diagnostic imaging
  • Corpus Callosum / pathology
  • Disease Progression
  • Female
  • Frontal Lobe / diagnostic imaging
  • Frontal Lobe / pathology
  • Frontotemporal Dementia / diagnostic imaging*
  • Frontotemporal Dementia / pathology
  • Gyrus Cinguli / diagnostic imaging
  • Gyrus Cinguli / pathology
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Organ Size
  • White Matter / diagnostic imaging
  • White Matter / pathology