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Does attentional dysfunction and thalamic atrophy predict decline in dementia with Lewy bodies?

Lookup NU author(s): Dr Sean Colloby, Professor Andrew BlamireORCiD, Josh Wood, Professor John O'Brien

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Abstract

© 2017 Elsevier Ltd. Introduction: To evaluate the clinical characteristics of DLB subjects who died within 1 year of assessment compared to those who survived and investigate their patterns of in vivo regional thalamic atrophy using structural MRI. Methods: Seventy subjects (35 DLB, 35 aged controls) underwent 3 T T1-weighted MR scanning as well as clinical and cognitive assessments, including a computerised assessment of attention. All subjects were contacted after 12 months for reassessment.For both hemispheres, using FSL FIRST, the thalamus was automatically segmented followed by inter-subject vertex-wise analyses involving group comparisons and behavioural correlates. Results: There was significant bilateral atrophy in the ventral-dorsal and pulvinar regions in DLB relative to controls (pcorrected < 0.05). The DLB group was then re-categorised based on 12-month mortality data: DLB-a (n = 26) and DLB-d (n = 9) (a = alive, d = death within 12 months of study assessment). Compared to controls, significant attentional dysfunction and bilateral atrophy of the pulvinar, ventral and dorsal nuclei were observed in DLB-d (pcorrected < 0.05), whereas in DLB-a, atrophy was far less extensive. Conclusions: Distinct patterns of thalamic atrophy occur in DLB that may relate to the attentional dysfunction and cognitive fluctuations that characterise this disorder. Relative to controls, the extent of attentional impairment and pattern of thalamic degeneration differ in those patients who died within 12 months of assessment, despite having an otherwise similar level of dementia severity. These findings may provide insight into the neurobiological changes underpinning important clinical characteristics and disease heterogeneity.

Publication metadata

Author(s): Watson R, Colloby SJ, Blamire AM, Wesnes KA, Wood J, O'Brien JT

Publication type: Article

Publication status: Published

Journal: Parkinsonism and Related Disorders

Year: 2017

Volume: 45

Pages: 69-74

Print publication date: 01/12/2017

Online publication date: 09/10/2017

Acceptance date: 08/10/2017

ISSN (print): 1353-8020

ISSN (electronic): 1873-5126

Publisher: Elsevier Ltd

URL: https://doi.org/10.1016/j.parkreldis.2017.10.006

DOI: 10.1016/j.parkreldis.2017.10.006

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