Detailed volumetric analysis of the hypothalamus in behavioral variant frontotemporal dementia.
Detailed volumetric analysis of the hypothalamus in behavioral variant frontotemporal dementia.
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DOI：
10.1007/s00415-015-7885-2
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发表时间：
2015-12
影响因子：
6
通讯作者：
Rohrer JD
中科院分区：
文献类型：
--
作者：
Bocchetta M;Gordon E;Manning E;Barnes J;Cash DM;Espak M;Thomas DL;Modat M;Rossor MN;Warren JD;Ourselin S;Frisoni GB;Rohrer JD
异常饮食行为是行为变异性额颞叶痴呆（bvFTD）的常见症状。下丘脑是进食和饱腹感的调节中心，但其在bvFTD中的作用尚未完全阐明，部分原因是其在MR图像上难以识别。我们测量了18名bvFTD患者（包括9名MAPT和6名C9orf72突变携带者）和18名认知正常对照者的下丘脑体积，使用了一种新的优化的多模态分割方案，结合3D T1和t2加权3T mri（类内相关系数≥0.93）。整个下丘脑随后被分割成五个亚单位：前（上和下）、结节（上和下）和后区域。使用修订版的剑桥行为量表（CBI-R）评估异常饮食行为的存在。bvFTD组显示下丘脑体积比对照组低17% (p < 0.001)：平均783（标准差113）比944 (73)mm3（校正总颅内容积）。在下丘脑亚单位分析中，与对照组相比，bvFTD组的前、结节上部和后区域明显变小。在CBI-R中进食障碍评分严重的患者，下丘脑体积有较小的趋势，尤其是在结节上区。与对照组相比，两个遗传亚组之间存在差异，MAPT的体积明显较小，但C9orf72组没有差异。总之，与对照组相比，bvFTD患者下丘脑体积更小。不同的基因突变可能对下丘脑有不同的影响。本文的在线版本（doi:10.1007/s00415-015-7885-2）包含补充材料，仅供授权用户使用。
Abnormal eating behaviors are frequently reported in behavioral variant frontotemporal dementia (bvFTD). The hypothalamus is the regulatory center for feeding and satiety but its involvement in bvFTD has not been fully clarified, partly due to its difficult identification on MR images. We measured hypothalamic volume in 18 patients with bvFTD (including 9 MAPT and 6 C9orf72 mutation carriers) and 18 cognitively normal controls using a novel optimized multimodal segmentation protocol, combining 3D T1 and T2-weighted 3T MRIs (intrarater intraclass correlation coefficients ≥0.93). The whole hypothalamus was subsequently segmented into five subunits: the anterior (superior and inferior), tuberal (superior and inferior), and posterior regions. The presence of abnormal eating behavior was assessed with the revised version of the Cambridge Behavioural Inventory (CBI-R). The bvFTD group showed a 17 % lower hypothalamic volume compared with controls (p < 0.001): mean 783 (standard deviation 113) versus 944 (73) mm3 (corrected for total intracranial volume). In the hypothalamic subunit analysis, the superior parts of the anterior and tuberal regions and the posterior region were significantly smaller in the bvFTD group compared with controls. There was a trend for a smaller hypothalamic volume, particularly in the superior tuberal region, in those with severe eating disturbance scores on the CBI-R. Differences were seen between the two genetic subgroups with significantly smaller volumes in the MAPT but not the C9orf72 group compared with controls. In summary, bvFTD patients had lower hypothalamic volumes compared with controls. Different genetic mutations may have a differential impact on the hypothalamus. The online version of this article (doi:10.1007/s00415-015-7885-2) contains supplementary material, which is available to authorized users.