Differentiating normal from pathological atrophy: when is frontotemporal atrophy normal?

Tiffany W. Chow

in Amyotrophic Lateral Sclerosis and the Frontotemporal Dementias

Published on behalf of Oxford University Press

Published in print October 2012 | ISBN: 9780199590674
Published online November 2012 | e-ISBN: 9780191753466 | DOI:
Differentiating normal from pathological atrophy: when is frontotemporal atrophy normal?

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Although we would all prefer to believe that our brains will not atrophy with age, it has been widely observed that the frontal lobe atrophies as we age, to an extent greater than the other lobes. For example, the ratio of frontal pole to total brain volume decreases over age 20 to 40 years in normal controls. Raz and colleagues have shown in volumetric studies that the dorsolateral prefrontal cortex, as opposed to the anterior cingulate gyrus or the orbitofrontal cortex shows the most substantial age-related decline.

In a binary logistic regression analysis to determine which semiautomated volumetrics could discriminate patients with frontotemporal dementia (FTD) from healthy controls, only two regions within the frontal and temporal lobes were helpful. The left anterior cingulate and left anterior temporal regions were most consistently atrophied in patients with FTD, and this applied to behavioural variant FTD as well as cases with primary progressive aphasia. Three control subjects had subthreshold volumes for either the left anterior temporal or the left anterior cingulate volumes of interest, but none of these three were subthreshold for both volumes of interest.

Chapter.  1353 words.  Illustrated.

Subjects: Neurology

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