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A Volumetric Magnetic Resonance Imaging Study of the Amygdala in Frontotemporal Lobar Degeneration and Alzheimer’s DiseaseWhitwell J.L.a, b · Sampson E.L.a, c · Watt H.C.a, d · Harvey R.J.a, e · Rossor M.N.a, f · Fox N.C.a
aDementia Research Centre, Institute of Neurology, University College London, London, UK; bDepartment of Diagnostic Radiology, Mayo Clinic, Rochester, Minn., USA; cDepartment of Mental Health Sciences, Royal Free and University College Medical School, London, UK; dMedical Statistics Unit, London School of Hygiene and Tropical Medicine, London, UK; eDepartment of Clinical and Biomedical Science, University of Melbourne, Melbourne, Australia; fDivision of Neuroscience and Psychological Medicine, Imperial College London, London, UK Corresponding Author
Prof. Nick Fox
Dementia Research Centre, National Hospital for Neurology and Neurosurgery
8–11 Queen Square, London WC1N 3BG (UK)
Tel. +44 207 829 8773, Fax +44 207 676 2066
The amygdala is severely atrophied at post-mortem in frontotemporal lobar degeneration (FTLD), and may contribute to the prominent behavioural changes that are early features of FTLD. The aim of this study was to assess amygdala atrophy using MRI in the main syndromic variants of FTLD and Alzheimer’s disease (AD). Brain and amygdala volumes, adjusted for intracranial volume, were measured on 46 clinically diagnosed FTLD patients [22 frontal variant FTD (FTD), 14 semantic dementia (SD), 10 progressive non-fluent aphasia (PNFA)], 20 AD patients, and 17 controls. While severe amygdala atrophy was present in both FTLD (41% smaller than controls on the left; 33% on the right) and in AD (22% on the left; 19% on the right), the FTLD group had significantly greater amygdala atrophy (z = 3.21, p = 0.001 left, z = 2.50, p = 0.01 right) and left/right asymmetry (z = 2.03, p = 0.04) than AD. Amygdala atrophy was greater in SD than FTD, PNFA and AD (p < 0.02 for all). Highly asymmetrical atrophy was present in SD, greater on the left (z = 3.23, p = 0.001), and to a lesser extent in PNFA. Despite an overlap between clinical and radiological features of FTLD and AD, marked amygdala atrophy points towards a diagnosis of FTLD, with left greater than right atrophy suggestive of one of the language variants.
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