Skip to main content

Advertisement

SpringerLink
Log in

The common dementias: a pictorial review

  • Neuro
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Imaging plays an important role in the diagnosis and management of dementia. This review covers the imaging features of the most common dementing illnesses: Alzheimer’s disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB) and frontotemporal lobar degeneration (FTLD). It describes typical findings on structural neuroimaging and discusses functional and molecular imaging techniques such as FDG PET, amyloid PET, magnetic resonance (MR) perfusion imaging, diffusion tensor imaging (DTI) and functional MR imaging (fMRI).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16

Similar content being viewed by others

References

  1. Barkhof F, Fox NC, Bastos-Leite AJ, Scheltens P (2011) Neuroimaging in dementia. Springer, Heidelberg, pp 62–66

    Book  Google Scholar 

  2. Farlow M (2007) Alzheimer’s disease. Continuum Lifelong Learn Neurol 13:39–68

    Article  Google Scholar 

  3. Terry RD, Peck A, DeTeresa R, Schechter R, Horoupian DS (1981) Some morphometric aspects of the brain in senile dementia of the Alzheimer type. Ann Neurol 10:184–192

    Article  PubMed  CAS  Google Scholar 

  4. Terry RD, Masliah E, Salmon DP et al (1991) Physical basis of cognitive alterations in Alzheimer’s disease: synapse loss is the major correlate of cognitive impairment. Ann Neurol 30:572–580

    Article  PubMed  CAS  Google Scholar 

  5. Braak H, Braak E (1994) Morphological criteria for the recognition of Alzheimer’s disease and the distribution pattern of cortical changes related to this disorder. Neurobiol Aging 15:355–356, discussion 79–80

    Article  PubMed  CAS  Google Scholar 

  6. Tomlinson BE, Blessed G, Roth M (1970) Observations on the brains of demented old people. J Neurol Sci 11:205–242

    Article  PubMed  CAS  Google Scholar 

  7. Farias ST, Mungas D, Reed BR, Harvey D, DeCarli C (2009) Progression of mild cognitive impairment to dementia in clinic- vs community-based cohorts. Arch Neurol 66:1151–1157

    Article  PubMed  Google Scholar 

  8. Jack CR Jr, Weigand SD, Shiung MM et al (2008) Atrophy rates accelerate in amnestic mild cognitive impairment. Neurology 70:1740–1752

    Article  PubMed  Google Scholar 

  9. McKhann GM, Knopman DS, Chertkow H et al (2011) The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 7:263–269

    Article  PubMed  Google Scholar 

  10. Jack CR Jr (2012) Alzheimer disease: new concepts on its neurobiology and the clinical role imaging will play. Radiology 263:344–361

    Article  PubMed  Google Scholar 

  11. Jack CR Jr, Knopman DS, Jagust WJ et al (2010) Hypothetical model of dynamic biomarkers of the Alzheimer’s pathological cascade. Lancet Neurol 9:119–128

    Article  PubMed  CAS  Google Scholar 

  12. Qiu C, Kivipelto M, von Strauss E (2009) Epidemiology of Alzheimer’s disease: occurrence, determinants and strategies toward intervention. Dialogues Clin Neurosci 11:111–128

    PubMed  Google Scholar 

  13. Janssen JC, Beck JA, Campbell TA et al (2003) Early onset familial Alzheimer’s disease: mutation frequency in 31 families. Neurology 60:235–239

    Article  PubMed  CAS  Google Scholar 

  14. St George-Hyslop PH, Tanzi RE, Polinsky RJ et al (1987) The genetic defect causing familial Alzheimer’s disease maps on chromosome 21. Science 235:885–890

    Article  PubMed  CAS  Google Scholar 

  15. Davies P (1986) The genetics of Alzheimer’s disease: a review and a discussion of the implications. Neurobiol Aging 7:459–466

    Article  PubMed  CAS  Google Scholar 

  16. Goate A, Chartier-Harlin MC, Mullan M et al (1991) Segregation of a missense mutation in the amyloid precursor protein gene with familial Alzheimer’s disease. Nature 349:704–706

    Article  PubMed  CAS  Google Scholar 

  17. Levy-Lahad E, Wasco W, Poorkaj P et al (1995) Candidate gene for the chromosome 1 familial Alzheimer’s disease locus. Science 269:973–977

    Article  PubMed  CAS  Google Scholar 

  18. Sherrington R, Rogaev EI, Liang Y et al (1995) Cloning of a gene bearing missense mutations in early-onset familial Alzheimer’s disease. Nature 375:754–760

    Article  PubMed  CAS  Google Scholar 

  19. Scheuner D, Eckman C, Jensen M et al (1996) Secreted amyloid beta-protein similar to that in the senile plaques of Alzheimer’s disease is increased in vivo by the presenilin 1 and 2 and APP mutations linked to familial Alzheimer’s disease. Nature Med 2:864–780

    Article  PubMed  CAS  Google Scholar 

  20. Cavedo E, Boccardi M, Ganzola R et al (2011) Local amygdala structural differences with 3T MRI in patients with Alzheimer disease. Neurology 22:727–733

    Article  Google Scholar 

  21. Jack CR Jr, Shiung MM, Gunter JL et al (2004) Comparison of different MRI brain atrophy rate measures with clinical disease progression in AD. Neurology 62:591–600

    Article  PubMed  Google Scholar 

  22. Jack CR Jr, Petersen RC, Xu Y et al (1998) Rate of medial temporal lobe atrophy in typical aging and Alzheimer’s disease. Neurology 51:993–999

    Article  PubMed  Google Scholar 

  23. De Leon MJ, George AE, Golomb J et al (1997) Frequency of hippocampal formation atrophy in normal aging and Alzheimer’s disease. Neurobiol Aging 18:1–11

    Article  PubMed  Google Scholar 

  24. de Toledo-Morrell L, Dickerson B, Sullivan MP, Spanovic C, Wilson R, Bennett DA (2000) Hemispheric differences in hippocampal volume predict verbal and spatial memory performance in patients with Alzheimer’s disease. Hippocampus 10:136–142

    Article  PubMed  Google Scholar 

  25. Uotani C, Sugimori K, Kobayashi K (2006) Association of minimal thickness of the medial temporal lobe with hippocampal volume, maximal and minimal hippocampal length: volumetric approach with horizontal magnetic resonance imaging scans for evaluation of a diagnostic marker for neuroimaging of Alzheimer’s disease. Psychiatry Clin Neurosci 60:319–326

    Article  PubMed  Google Scholar 

  26. Scheltens P, Launer LJ, Barkhof F, Weinstein HC, van Gool WA (1995) Visual assessment of medial temporal lobe atrophy on magnetic resonance imaging: interobserver reliability. J Neurol 242:557–560

    Article  PubMed  CAS  Google Scholar 

  27. Wattjes MP, Henneman WJ, van der Flier WM et al (2009) Diagnostic imaging of patients in a memory clinic: comparison of MR imaging and 64-detector row CT. Radiology 253:174–183

    Article  PubMed  Google Scholar 

  28. Leung KK, Clarkson MJ, Bartlett JW, Clegg S, Jack CR Jr, Weiner MW, Fox NC, Ourselin S (2010) Robust atrophy rate measurement in Alzheimer’s disease using multi-site serial MRI: tissue-specific intensity normalization and parameter selection. Neuroimage 50:516–523

    Article  PubMed  Google Scholar 

  29. Klunk WE, Engler H, Nordberg A et al (2004) Imaging brain amyloid in Alzheimer’s disease with Pittsburgh Compound-B. Ann Neurol 55:306–319

    Article  PubMed  CAS  Google Scholar 

  30. Mathis CA, Kuller LH, Klunk WE et al (2013) In vivo assessment of amyloid-beta deposition in nondemented very elderly subjects. Ann Neurol 76:751–761

    Article  Google Scholar 

  31. Musiek ES, Chen Y, Korczykowski M et al (2012) Direct comparison of fluorodeoxyglucose positron emission tomography and arterial spin labeling magnetic resonance imaging in Alzheimer’s disease. Alzheimers Dement 8:51–59

    Article  PubMed  Google Scholar 

  32. Yoshiura T, Hiwatashi A, Noguchi T et al (2009) Arterial spin labelling at 3-T MR imaging for detection of individuals with Alzheimer’s disease. Eur Radiol 19:2819–2825

    Article  PubMed  Google Scholar 

  33. Sexton CE, Kalu UG, Filippini N, Mackay CE, Ebmeier KP (2011) A meta-analysis of diffusion tensor imaging in mild cognitive impairment and Alzheimer’s disease. Neurobiol Aging 32:5–18

    Article  Google Scholar 

  34. Mielke MM, Kozauer NA, Chan KC et al (2009) Regionally-specific diffusion tensor imaging in mild cognitive impairment and Alzheimer’s disease. Neuroimage 46:47–55

    Article  PubMed  CAS  Google Scholar 

  35. Greicius MD, Srivastava G, Reiss AL, Menon V (2004) Default-mode network activity distinguishes Alzheimer’s disease from healthy aging: evidence from functional MRI. Proc Natl Acad Sci U S A 101:4637–4642

    Article  PubMed  CAS  Google Scholar 

  36. Filippini N, MacIntosh BJ, Hough MG et al (2009) Distinct patterns of brain activity in young carriers of the APOE-epsilon4 allele. Proc Natl Acad Sci U S A 106:7209–7214

    Article  PubMed  CAS  Google Scholar 

  37. Renner JA, Burns JM, Hou CE, McKeel DW Jr, Storandt M, Morris JC (2004) Progressive posterior cortical dysfunction: a clinicopathologic series. Neurology 63:1175–1180

    Article  PubMed  CAS  Google Scholar 

  38. Tang-Wai DF, Graff-Radford NR, Boeve BF et al (2004) Clinical, genetic, and neuropathologic characteristics of posterior cortical atrophy. Neurology 63:1168–1174

    Article  PubMed  CAS  Google Scholar 

  39. Lehmann M, Crutch SJ, Ridgway GR et al (2011) Cortical thickness and voxel-based morphometry in posterior cortical atrophy and typical Alzheimer’s disease. Neurobiol Aging 32:1466–1476

    Article  PubMed  Google Scholar 

  40. Whitwell JL, Jack CR Jr, Kantarci K et al (2007) Imaging correlates of posterior cortical atrophy. Neurobiol Aging 28:1051–1061

    Article  PubMed  Google Scholar 

  41. Koedam ELGE, Lehmann M, van der Flier WM et al (2011) Visual assessment of posterior atrophy development of a MRI rating scale. Eur Radiol 21:2618–2625

    Article  PubMed  Google Scholar 

  42. Wakai M, Honda H, Takahashi A, Kato T, Ito K, Hamanaka T (1994) Unusual findings on PET study of a patient with posterior cortical atrophy. Acta Neurol Scand 89:458–461

    Article  PubMed  CAS  Google Scholar 

  43. Iemolo F, Duro G, Rizzo C, Castiglia L, Hachinski V, Caruso C (2009) Pathophysiology of vascular dementia. Immun Ageing 6:13

    Article  PubMed  Google Scholar 

  44. Enciu AM, Constantinescu SN, Popescu LM, Muresanu DF, Popescu BO (2011) Neurobiology of vascular dementia. J Aging Res 2011:401604

  45. Lee AY (2011) Vascular dementia. Chonnam Med J 47:66–71

    Article  PubMed  Google Scholar 

  46. Fratiglioni L, Rocca WA (2001) Epidemiology of dementia. In: Boller F, Cappa SF (eds) Handbook of neuropsychology, 2nd edn. Elsevier, Amsterdam, pp 193–215

    Google Scholar 

  47. O’Brien JT, Erkinjuntti T, Reisberg B et al (2003) Vascular cognitive impairment. Lancet Neurol 2:89–98

    Article  PubMed  Google Scholar 

  48. Leys D, Henon H, Mackowiak-Cordoliani MA, Pasquier F (2005) Poststroke dementia. Lancet Neurol 4:752–759

    Article  PubMed  Google Scholar 

  49. Korczyn AD, Vakhapova V, Grinberg LT (2012) Vascular dementia. J Neurol Sci 322:2–10

    Article  PubMed  Google Scholar 

  50. Ikeda M, Hokoishi K, Maki N et al (2001) Increased prevalence of vascular dementia in Japan: a community-based epidemiological study. Neurology 57:839–844

    Article  PubMed  CAS  Google Scholar 

  51. Skoog I, Korczyn AD, Guekht A (2012) Neuroprotection in vascular dementia: a future path. J Neurol Sci 322:232–236

    Article  PubMed  Google Scholar 

  52. Koga H, Takashima Y, Murakawa R, Uchino A, Yuzuriha T, Yao H (2009) Cognitive consequences of multiple lacunes and leukoaraiosis as vascular cognitive impairment in community-dwelling elderly individuals. J Stroke Cerebrovasc Dis 18:32–37

    Article  PubMed  Google Scholar 

  53. van Straaten EC, Scheltens P, Knol DL, van Buchem MA, van Dijk EJ, Hofman PA et al (2003) Operational definitions for NINDS-AIREN criteria for vascular dementia. An interobserver study. Stroke 34:1907–1912

    Article  PubMed  Google Scholar 

  54. Wardlaw JM, Smith EE, Biessels GJ et al (2013) Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. STandards for ReportIng Vascular changes on nEuroimaging (STRIVE v1). Lancet Neurol 12:822–838

    Article  PubMed  Google Scholar 

  55. Handley A, Medcalf P, Hellier K, Dutta D (2009) Movement disorders after stroke. Age Ageing 38:260–266

    Article  PubMed  Google Scholar 

  56. Udaka F, Sawada H, Kameyama M (2002) White matter lesions and dementia: MRI-pathological correlation. Ann N Y Acad Sci 977:411–415

    Article  PubMed  Google Scholar 

  57. Charidimou A, Werring DJ (2012) Cerebral microbleeds and cognition in cerebrovascular disease: an update. J Neurol Sci 322:50–55

    Article  PubMed  Google Scholar 

  58. Bastos-Leite AJ, Kuijer JP, Rombouts SA et al (2008) Cerebral blood flow by using pulsed arterial spin-labeling in elderly subjects with white matter hyperintensities. AJNR Am J Neuroradiol 29:1296–1301

    Article  PubMed  CAS  Google Scholar 

  59. Chabriat H, Joutel A, Dichgans M, Tournier-Lasserve E, Bousser MG (2009) Cadasil. Lancet Neurol 8:643–653

    Article  PubMed  Google Scholar 

  60. Hansen L, Salmon D, Galasko D et al (1990) The Lewy body variant of Alzheimer’s disease: a clinical and pathologic entity. Neurology 40:1–8

    Article  PubMed  CAS  Google Scholar 

  61. Perry RH, Irving D, Blessed G, Fairbairn A, Perry EK (1990) Senile dementia of Lewy body type. A clinically and neuropathologically distinct form of Lewy body dementia in the elderly. J Neurol Sci 95:119–139

    Article  PubMed  CAS  Google Scholar 

  62. McKeith IG, Dickson DW, Lowe J et al (2005) Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology 65:1863–1872

    Article  PubMed  CAS  Google Scholar 

  63. Emre M, Aarsland D, Brown R et al (2007) Clinical diagnostic criteria for dementia associated with Parkinson’s disease. Mov Disord 22:1689–1707, quiz 837

    Article  PubMed  Google Scholar 

  64. Burton EJ, Karas G, Paling SM et al (2002) Patterns of cerebral atrophy in dementia with Lewy bodies using voxel-based morphometry. Neuroimage 17:618–630

    Article  PubMed  CAS  Google Scholar 

  65. Marshall VL, Patterson J, Hadley DM, Grosset KA, Grosset DG (2006) Two-year follow-up in 150 consecutive cases with normal dopamine transporter imaging. Nucl Med Commun 27:933–937

    Article  PubMed  Google Scholar 

  66. McKeith I, O’Brien J, Walker Z et al (2007) Sensitivity and specificity of dopamine transporter imaging with 123I-FP-CIT SPECT in dementia with Lewy bodies: a phase III, multicentre study. Lancet Neurol 6:305–313

    Article  PubMed  Google Scholar 

  67. Walker Z, Jaros E, Walker RW et al (2007) Dementia with Lewy bodies: a comparison of clinical diagnosis, FP-CIT single photon emission computed tomography imaging and autopsy. J Neurol Neurosurg Psychiatry 78:1176–1181

    Article  PubMed  Google Scholar 

  68. Treglia G, Cason E (2012) Diagnostic performance of myocardial innervation imaging using MIBG scintigraphy in differential diagnosis between dementia with Lewy bodies and other dementias: a systematic review and a meta-analysis. J Neuroimaging 22:111–117

    Article  PubMed  Google Scholar 

  69. Gallucci M, Limbucci N, Catalucci A, Caulo M (2008) Neurodegenerative diseases. Radiol Clin North Am 46:799–817, vii

    Article  PubMed  Google Scholar 

  70. Seelaar H, Rohrer JD, Pijnenburg YA, Fox NC, van Swieten JC (2011) Clinical, genetic and pathological heterogeneity of frontotemporal dementia: a review. J Neurol Neurosurg Psychiatry 82:476–486

    Article  PubMed  Google Scholar 

  71. Gorno-Tempini ML, Dronkers NF, Rankin KP et al (2004) Cognition and anatomy in three variants of primary progressive aphasia. Ann Neurol 55:335–346

    Article  PubMed  Google Scholar 

  72. Seelaar H, Kamphorst W, Rosso SM et al (2008) Distinct genetic forms of frontotemporal dementia. Neurology 71:1220–1226

    Article  PubMed  CAS  Google Scholar 

  73. Cairns NJ, Bigio EH, Mackenzie IR et al (2007) Neuropathologic diagnostic and nosologic criteria for frontotemporal lobar degeneration: consensus of the Consortium for Frontotemporal Lobar Degeneration. Acta Neuropathol 114:5–22

    Article  PubMed  Google Scholar 

  74. Rohrer JD, Lashley T, Schott JM et al (2011) Clinical and neuroanatomical signatures of tissue pathology in frontotemporal lobar degeneration. Brain 134:2565–2581

    Article  PubMed  Google Scholar 

  75. Josephs KA (2007) Frontotemporal lobar degeneration. Neurol Clin 25:683–696, vi

    Article  PubMed  Google Scholar 

  76. Fukui T, Kertesz A (2000) Volumetric study of lobar atrophy in Pick complex and Alzheimer’s disease. J Neurol Sci 174:111–121

    Article  PubMed  CAS  Google Scholar 

  77. Chan D, Fox NC, Scahill RI et al (2001) Patterns of temporal lobe atrophy in semantic dementia and Alzheimer’s disease. Ann Neurol 49:433–442

    Article  PubMed  CAS  Google Scholar 

  78. Kipps CM, Davies RR, Mitchell J et al (2007) Clinical significance of lobar atrophy in frontotemporal dementia: application of an MRI visual rating scale. Dement Geriatr Cogn Disord 23:334–342

    Article  PubMed  Google Scholar 

  79. Mahoney CJ, Beck J, Rohrer JD et al (2012) Frontotemporal dementia with the C9ORF72 hexanucleotide repeat expansion: clinical, neuroanatomical and neuropathological features. Brain 135:736–750

    Article  PubMed  Google Scholar 

  80. Rosen HJ, Gorno-Tempini ML, Goldman WP et al (2002) Patterns of brain atrophy in frontotemporal dementia and semantic dementia. Neurology 58:198–208

    Article  PubMed  CAS  Google Scholar 

  81. Du AT, Schuff N, Kramer JH et al (2007) Different regional patterns of cortical thinning in Alzheimer’s disease and frontotemporal dementia. Brain 130:1159–1166

    Article  PubMed  Google Scholar 

  82. Foster NL, Heidebrink JL, Clark CM et al (2007) FDG-PET improves accuracy in distinguishing frontotemporal dementia and Alzheimer’s disease. Brain 130:2616–2635

    Article  PubMed  Google Scholar 

  83. Vitali P, Migliaccio R, Agosta F et al (2008) Neuroimaging in dementia. Semin Neurol 28:467–483

    Article  PubMed  Google Scholar 

  84. Diehl-Schmid J, Grimmer T, Drzezga A et al (2007) Decline of cerebral glucose metabolism in frontotemporal dementia: a longitudinal 18F-FDG-PET-study. Neurobiol Aging 28:42–50

    Article  PubMed  CAS  Google Scholar 

  85. Zhang Y, Schuff N, Du AT et al (2009) White matter damage in frontotemporal dementia and Alzheimer’s disease measured by diffusion MRI. Brain 132:2579–2592

    Article  PubMed  Google Scholar 

  86. Mahoney CJ, Malone IB, Ridgway GR et al (2013) White matter tract signatures of the progressive aphasias. Neurobiol Aging 34:1687–1699

    Article  PubMed  Google Scholar 

  87. Galantucci S, Tartaglia MC, Wilson SM et al (2011) White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain 134:3011–3029

    Article  PubMed  Google Scholar 

  88. Zhou J, Greicius MD, Gennatas ED et al (2010) Divergent network connectivity changes in behavioural variant frontotemporal dementia and Alzheimer’s disease. Brain 133:1352–1367

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK

    Pervinder Bhogal, Sophie Graeme-Baker, Amit Roy, Sachit Shah & Peter Cowley

  2. Dementia Research Centre, Department of Neurodegenerative Diseases UCL Institute of Neurology, London, UK

    Colin Mahoney

  3. Institute of Nuclear Medicine, University College London, London, UK

    Francesco Fraioli

  4. Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, Queen Square, Box 65, 8-11, London, WC1N 3BG, UK

    Hans Rolf Jäger

Authors
  1. Pervinder Bhogal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Colin Mahoney
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sophie Graeme-Baker
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Amit Roy
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sachit Shah
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Francesco Fraioli
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Peter Cowley
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hans Rolf Jäger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pervinder Bhogal.

Additional information

Editor’s note

Readers will notice that this issue contains two rather similar review articles on the imaging of dementia. Both articles try to help the average radiologist identify key features which may require expert neuroradiological attention. Two groups spontaneously submitted a review article at roughly the same time. There were merits in both papers; both were favourably reviewed. It was an impossible editorial choice to select one paper over another and hence both are published alongside each other. It will be interesting to see whether the astute readers will identify differences. Indeed this may lead to some interesting discussion in the opinion column on the journal’s website.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bhogal, P., Mahoney, C., Graeme-Baker, S. et al. The common dementias: a pictorial review. Eur Radiol 23, 3405–3417 (2013). https://doi.org/10.1007/s00330-013-3005-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-013-3005-9

Keywords

Search

Navigation