Structural and metabolic cerebral alterations between elderly bipolar disorder and behavioural variant frontotemporal dementia: A combined MRI-PET study

Author:

Delvecchio Giuseppe1,Mandolini Gian Mario12ORCID,Arighi Andrea123,Prunas Cecilia12,Mauri Carlo Massimo2,Pietroboni Anna M123,Marotta Giorgio2,Cinnante Claudia Maria2,Triulzi Fabio Maria12,Galimberti Daniela123,Scarpini Elio123,Altamura Alfredo Carlo12,Brambilla Paolo14

Affiliation:

1. Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

2. Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

3. ‘Dino Ferrari’ Center, Milan, Italy

4. Department of Psychiatry and Behavioural Sciences, UT Houston Medical School, Houston, TX, USA

Abstract

Background: Elderly bipolar disorder (BD) and behavioural variant of frontotemporal dementia (bvFTD) may exhibit similar symptoms and both disorders are characterized by selective abnormalities in cortical and subcortical regions that are associated with cognitive and emotional impairments. We aimed to investigate common and distinct neural substrates of BD and bvFTD by coupling, for the first time, magnetic resonance imaging (MRI) and positron emission tomography (PET) techniques. Methods: 3-Tesla MRI and 18 fluorodeoxyglucose–PET scans were acquired for 16 elderly BD patients, 23 bvFTD patients with mild cognitive impairments and 68 healthy controls (48 for PET and 20 for MRI analyses). Results: BD and bvFTD patients exhibit a different localization of grey matter reductions in the lateral prefrontal cortex, with the first group showing grey matter decrease in the ventrolateral prefrontal cortex and the latter group showing grey matter reductions in the dorsolateral prefrontal cortex as well as unique grey matter and metabolic alterations within the orbitofrontal cortex. The bvFTD group also displayed unique volumetric shrinkage in regions within the temporo-parietal network together with greater metabolic impairments within the temporal cortex and more extensive volumetric and metabolic abnormalities within the limbic lobe. Finally, while the BD group showed greater grey matter volumes in caudate nucleus, bvFTD subjects displayed lower metabolism. Conclusion: This MRI-PET study explored, for the first time to the best of our knowledge, structural and functional abnormalities in bvFTD and elderly BD patients, with the final aim of identifying the specific biological signature of these disorders, which might have important implications not only in prevention but also in differential diagnosis and treatment.

Funder

Ministero della Salute

Fondazione Cariplo

Publisher

SAGE Publications

Subject

Psychiatry and Mental health,General Medicine

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