Occipital atrophy signature in prodromal Lewy bodies disease

INTRODUCTIONDementia with Lewy bodies (DLB) is typically characterized by parietal, temporal, and occipital atrophy, but less is known about the newly defined prodromal phases. The objective of this study was to evaluate structural brain alterations in prodromal DLB (p-DLB) as compared to healthy controls (HC) and full-blown dementia (DLB-DEM).METHODSThe study included 42 DLB patients (n = 20 p-DLB; n = 22 DLB-DEM) and 27 HC with a standardized neurological assessment and 3-tesla magnetic resonance imaging. Voxel-wise analyses on gray-matter and cortical thickness were implemented to evaluate differences between p-DLB, DLB-DEM, and HC.RESULTSp-DLB and DLB-DEM exhibited reduced occipital and posterior parieto-temporal volume and thickness, extending from prodromal to dementia stages. Occipital atrophy was more sensitive than insular atrophy in differentiating p-DLB and HC. Occipital atrophy correlated to frontotemporal structural damage increasing from p-DLB to DLB-DEM.DISCUSSIONOccipital and posterior-temporal structural alterations are an early signature of the DLB continuum and correlate with a long-distance pattern of atrophy.

Automated summary

This study found that prodromal DLB and full-blown dementia stages are characterized by reduced occipital and posterior-temporal volume and thickness. Occipital atrophy is more sensitive than insular atrophy in differentiating prodromal DLB and healthy controls. The structural damage in the frontotemporal area increases along with occipital atrophy from prodromal DLB to full-blown dementia.