Metric magnetic resonance imaging analysis reveals pronounced substantia-innominata atrophy in dementia with Lewy bodies with a psychiatric onset

Niels Hansen; Sebastian Johannes Müller; Eya Khadhraoui; Christian Heiner Riedel; Philip Langer; Jens Wiltfang; Charles-Arnold Timäus; Caroline Bouter; Marielle Ernst; Claudia Lange

doi:10.3389/fnagi.2022.815813

Metric magnetic resonance imaging analysis reveals pronounced substantia-innominata atrophy in dementia with Lewy bodies with a psychiatric onset

Front Aging Neurosci. 2022 Oct 5:14:815813. doi: 10.3389/fnagi.2022.815813. eCollection 2022.

Affiliations

¹ Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.
² Institute of Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Göttingen, Germany.
³ German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany.
⁴ Neurosciences and Signaling Group, Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal.
⁵ Department of Nuclear Medicine, University Medical Center Göttingen (UMG), Georg August University, Göttingen, Germany.

Abstract

Background: Dementia with Lewy bodies (DLB) is a type of dementia often diagnosed in older patients. Since its initial symptoms range from delirium to psychiatric and cognitive symptoms, the diagnosis is often delayed.

Objectives: In our study, we evaluated the magnetic resonance imaging (MRI) of patients suffering from DLB in correlation with their initial symptoms taking a new pragmatic approach entailing manual measurements in addition to an automated volumetric analysis of MRI.

Methods: A total of 63 patients with diagnosed DLB and valid 3D data sets were retrospectively and blinded evaluated. We assessed atrophy patterns (1) manually for the substantia innominata and (2) via FastSurfer for the most common supratentorial regions. Initial symptoms were categorized by (1) mild cognitive impairment (MCI), (2) psychiatric episodes, and (3) delirium.

Results: Manual metric MRI measurements revealed moderate, but significant substantia-innominata (SI) atrophy in patients with a psychiatric onset. FastSurfer analysis revealed no regional volumetric differences between groups.

Conclusion: The SI in patients with DLB and a psychiatric-onset is more atrophied than that in patients with initial MCI. Our results suggest potential differences in SI between DLB subtypes at the prodromal stage, which are useful when taking a differential-diagnostic approach. This finding should be confirmed in larger patient cohorts.

Keywords: Lewy body dementia; MRI; atrophy; psychiatry; substantia innominata.