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Valerie A. Cardenas, PhD; Adam L. Boxer, MD, PhD; Linda L. Chao, PhD; Maria L. Gorno-Tempini, MD, PhD; Bruce L. Miller, MD; Michael W. Weiner, MD; Colin Studholme, PhD

Arch Neurol. 2007;64(6):873-877.

Objective  To compare deformation-based maps of local anatomical size between subjects with frontotemporal dementia (FTD) and healthy subjects to identify regions of the brain involved in FTD.

Design  Structural magnetic resonance images were obtained from 22 subjects with FTD and 22 cognitively normal, age-matched controls. We applied deformation-based morphometry and compared anatomy between groups using an analysis of covariance model that included a categorical variable denoting group membership and covaried for head size.

Setting  University of California, San Francisco, Memory and Aging Center, and the San Francisco Veterans Affairs Medical Center.

Patients  Twenty-two subjects with FTD and 22 cognitively normal, age-matched controls.

Interventions  Neurological, neuropsychological, and functional evaluations and magnetic resonance imaging.

Main Outcome Measure  Deformation maps of local anatomical size.

Results  Patients with FTD showed extensive, significant atrophy of the frontal lobes, affecting both gray matter and white matter. Atrophy of similar magnitude but less significance was observed in the anterior temporal lobes. The subcortical and midbrain regions, particularly the thalamus, pons, and superior and inferior colliculi, showed strongly significant atrophy of smaller magnitude.

Conclusions  We confirmed frontal and anterior temporal gray matter atrophy in FTD. The observed white matter loss, thalamic involvement, and midbrain atrophy are consistent with pathological findings in late-stage FTD. Dysfunction of ventral-frontal-brainstem circuitry may underlie some of the unique clinical features of FTD.

Author Affiliations: Magnetic Resonance Unit, San Francisco Veterans Affairs Medical Center (Drs Cardenas, Chao, Weiner, and Studholme), and Departments of Radiology (Drs Cardenas, Chao, Weiner, and Studholme) and Psychiatry (Dr Chao) and the Memory and Aging Center, Department of Neurology (Drs Boxer, Gorno-Tempini, and Miller), University of California, San Francisco.

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