PRODROMAL AND NON PRODROMAL DEMENTIA WITH LEWY BODIES AND ALZHEIMER'S DISEASE: A MULTIMODAL MRI APPROACH
2011) 17/41 (41% had onset after and 24/41 (59% before 65 years. We compared clinical, radiological, and CSF data at the initial valuation. Results: Late onset bvFTLD (mean age at onset: 7063 years; probable bvFTLD1/459% and presenile onset bvFTLD (mean age at onset 5965 years; probable bvFTLD1/471% had comparable mean disease duration at initial examination (363 years) and mean follow up duration (563 vs 564 years) MRI examination confirmed more frequent hippocampal atrophy (47% vs 21% and less lobar atrophy (18% vs 58% in late onset bvFTLD; this was clinically correlated to more frequent hippocampal memory deficit (53% vs 12.5% TEP FDG or SPECT HMPAO imaging detected focal hypometabolism/hypoperfusion in 53% vs 62.5% of the patients. Unexpectedly, no differences were found in CSF abeta1 42 (10976276 vs 10346236) T tau (2896214 vs 2316100) P tau (40617 vs 37615) and IATI index (260.6 vs 260.6) the ratio T tau/abeta1 42 (0.2660.16 vs 0.2360.10) and P tau/abeta1 42 (0.0460.01 vs 0.0460.01) were not different, either. In each group three subjects had high T tau or P Tau and one subject low abeta1 42. Conclusions:Late onset bvFTLD is not rare in clinical practice; we confirmed more hippocampal and global atrophy compared to presenile onset bvFTLD, clinically correlated to more frequent hippocampal memory loss. TEP FDG and SPECT HMPAO focal alterations were equally represented. Since no differences were found in CSF biomarkers, the differences between lateand presenile onset bvFTLD could not be explained by co existing AD pathology in older patients. They could instead be due to hippocampal sclerosis, known to be associated to FTLD. These data suggest the potential interest of CSF and metabolic markers in the differential diagnosis of late onset bv FTLD vs AD.
Alzheimer's Dementia