Shape Changes of the Basal Ganglia and Thalamus in Alzheimer's Disease: A Three-Year Longitudinal Study

Article type: Research Article

Authors: Cho, Hanna^{a; b} | Kim, Jeong-Hun^c | Kim, Changsoo^d | Ye, Byoung Seok^a | Kim, Hee Jin^a | Yoon, Cindy W.^a | Noh, Young^a | Kim, Geon Ha^a | Kim, Yeo Jin^a | Kim, Jung-Hyun^a | Kim, Chang-Hun^e | Kang, Sue J.^a | Chin, Juhee^a | Kim, Sung Tae^f | Lee, Kyung-Han^g | Na, Duk L.^a | Seong, Joon-Kyung^{h; *} | Seo, Sang Won^{a; *}

Affiliations: [a] Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea | [b] Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea | [c] Department of Computer and Radio Communications Engineering, Korea University, Seoul, Republic of Korea | [d] Department of Preventive Medicine and the Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Korea | [e] Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea | [f] Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea | [g] Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea | [h] Department of Biomedical Engineering, Korea University, Seoul, Republic of Korea

Correspondence: [*] Correspondence to: Sang Won Seo, MD, PhD, Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea. Tel.: +82 2 3410 1233; Fax: +82 2 3410 0052; E-mail: sangwonseo@empal.com; Joon-Kyung Seong, PhD, Department of Biomedical Engineering, Korea University, San 1, Jeongreung-dong, Seongbuk-gu, Seoul 136-703, Republic of Korea. Tel.: +82 2 940 2887; Fax: +82 2 940 2880; E-mail: jkseong@korea.ac.kr.

Abstract: Background:A large number of Alzheimer’s disease (AD) studies have focused on medial temporal and cortical atrophy, while changes in the basal ganglia or thalamus have received less attention. Objective:The aim of this study was to investigate the existence of progressive topographical shape changes in the basal ganglia (caudate nucleus, putamen, and globus pallidus) and thalamus concurrent with AD disease progression over three years. This study also examined whether declines in volumes of the basal ganglia or thalamus might be responsible for cognitive decline in patients with AD. Methods:Thirty-six patients with early stage AD and 14 normal control subjects were prospectively recruited for this study. All subjects were assessed with neuropsychological tests and MRI at baseline and Years 1 and 3. A longitudinal shape analysis of the basal ganglia and thalamus was performed by employing a boundary surface-based shape analysis method. Results:AD patients exhibited specific regional atrophy in the right caudate nucleus and the bilateral putamen at baseline, and as the disease progressed, regional atrophic changes in the left caudate nucleus were found to conform to a distinct topography after controlling the total brain volume. Volumetric decline of the caudate nucleus and putamen correlated with cognitive decline in frontal function after controlling for age, gender, education, follow-up years, and total brain volume changes. Conclusion:Our findings suggest that shape changes of the basal ganglia occurred regardless of whole brain atrophy as AD progressed and were also responsible for cognitive decline that was observed from the frontal function tests.

Keywords: Alzheimer's disease, basal ganglia, caudate nucleus, globus pallidus, putamen, shape, thalamus

DOI: 10.3233/JAD-132072

Journal: Journal of Alzheimer's Disease, vol. 40, no. 2, pp. 285-295, 2014