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Thalamic Involvement in Fluctuating Cognition in Dementia with Lewy Bodies: Magnetic Resonance Evidences

Lookup NU author(s): Dr John-Paul Taylor

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Abstract

Dementia with Lewy bodies (DLB) is characterized by fluctuation in cognition and attention. Thalamocortical connectivity and integrity of thalami are central to attentional function. We hypothesize that DLB patients with marked and frequent fluctuating cognition (flCog) have a loss of thalamocortical connectivity, an intrinsic disruption to thalamic structure and imbalances in thalamic neurotransmitter levels. To test this, magnetic resonance imaging (MRI), diffusion tensor imaging (DTI) and proton MR spectroscopy on thalami were performed on 16 DLB, 16 Alzheimer's disease (AD) and 13 healthy subjects. MRI and DTI were combined to subdivide thalami according to their cortical connectivity and to investigate microstructural changes in connectivity-defined thalamic regions. Compared with controls, lower N-acetyl-aspartate/total creatine (NAA/tCr) and higher total choline/total creatine (tCho/tCr) values were observed within thalami of DLB patients. tCho/tCr increase was found within right thalamus of DLB patients as compared with AD. This increase correlated with severity and frequency of flCog. As compared with controls, DLB patients showed bilateral damage within thalamic regions projecting to prefrontal and parieto-occipital cortices, whereas AD patients showed bilateral alteration within thalamic region projecting to temporal cortex. We posit that microstructural thalamic damage and cholinergic imbalance may be central to the etiology of flCog in DLB.


Publication metadata

Author(s): DelliPizzi S, Franciotti R, Taylor J-P, Thomas A, Tartaro A, Onofrj M, Bonanni L

Publication type: Article

Publication status: Published

Journal: Cerebral Cortex

Year: 2015

Volume: 25

Issue: 10

Pages: 3682-3689

Print publication date: 01/10/2015

Online publication date: 26/09/2014

Acceptance date: 26/09/2014

ISSN (print): 1047-3211

ISSN (electronic): 1460-2199

Publisher: Oxford University Press

URL: http://dx.doi.org/10.1093/cercor/bhu220

DOI: 10.1093/cercor/bhu220

PubMed id: 25260701


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