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Hippocampal atrophy on MRI in frontotemporal lobar degeneration and Alzheimer’s disease
  1. L A van de Pol1,
  2. A Hensel2,
  3. W M van der Flier1,
  4. P-J Visser1,
  5. Y A L Pijnenburg1,
  6. F Barkhof3,
  7. H Josef Gertz2,
  8. P Scheltens1
  1. 1Department of Neurology, Alzheimer Centre, VU Medical Centre, Amsterdam, Netherlands
  2. 2Department of Psychiatry, University of Leipzig, Leipzig, Germany
  3. 3Department of Radiology, Alzheimer Centre, VU Medical Centre, Amsterdam
  1. Correspondence to:
 Laura van de Pol
 VUMC, Department of Neurology, PO Box 7057, 1007 MB Amsterdam, Netherlands; L.vandepol{at}vumc.nl

Abstract

Background: Hippocampal atrophy on magnetic resonance imaging (MRI) is an early characteristic of Alzheimer’s disease. However, hippocampal atrophy may also occur in other dementias, such as frontotemporal lobar degeneration (FTLD).

Objective: To investigate hippocampal atrophy on MRI in FTLD and its three clinical subtypes, in comparison with Alzheimer’s disease, using volumetry and a visual rating scale.

Methods: 42 patients with FTLD (17 frontotemporal dementia, 13 semantic dementia, and 12 progressive non-fluent aphasia), 103 patients with Alzheimer’s disease, and 73 controls were included. Hippocampal volumetry and the easily applicable medial temporal lobe atrophy (MTA) rating scale were applied to assess hippocampal atrophy.

Results: Multivariate analysis of variance for repeated measures showed an effect of diagnostic group on hippocampal volume. There was a significant diagnosis by side (left v right) interaction. Both FTLD and Alzheimer’s disease showed hippocampal atrophy compared with controls. Results of the visual MTA rating scale confirmed these findings. Within the FTLD subtypes there were marked differences in hippocampal atrophy. Frontotemporal dementia and semantic dementia showed bilateral hippocampal atrophy, and in semantic dementia the left hippocampus was smaller than in Alzheimer’s disease. No significant hippocampal atrophy was detected in non-fluent progressive aphasia.

Conclusions: Hippocampal atrophy is not only a characteristic of Alzheimer’s disease but also occurs in FTLD. The three clinical subtypes of FTLD show different patterns of hippocampal atrophy.

  • AD, Alzheimer’s disease
  • CDR, Clinical Dementia Rating scale
  • FTD, frontotemporal dementia
  • FTLD, frontotemporal lobar degeneration
  • ICA, intracranial area
  • MTA, medial temporal lobe atrophy
  • PA, progressive non-fluent aphasia
  • SD, semantic dementia
  • hippocampus
  • Alzheimer’s disease
  • frontotemporal lobar degeneration
  • MRI

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Footnotes

  • Published Online First 25 November 2005

  • Competing interests: none declared. PS is associate editor of the Journal of Neurology, Neurosurgery and Psychiatry. He had no involvement in the review process.

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