Dementia with Lewy bodies (DLB) is characterized by preserved whole brain and medial temporal lobe volumes compared with Alzheimer's disease dementia (AD) on magnetic resonance imaging. However, frequently coexistent AD-type pathology may influence the pattern of regional brain atrophy rates in DLB patients. We investigated the pattern and magnitude of the atrophy rates from 2 serial MRIs in autopsy-confirmed DLB patients (n = 20) and mixed DLB/AD patients (n = 22), compared with AD (n = 30) and elderly nondemented control subjects (n = 15), followed antemortem. DLB patients without significant AD-type pathology were characterized by lower global and regional rates of atrophy, similar to control subjects. The mixed DLB/AD patients displayed greater atrophy rates in the whole brain, temporoparietal cortices, hippocampus and amygdala, and ventricle expansion, similar to AD patients. In the DLB and DLB/AD patients, the atrophy rates correlated with Braak neurofibrillary tangle stage, cognitive decline, and progression of motor symptoms. Global and regional atrophy rates are associated with AD-type pathology in DLB, and these rates can be used as biomarkers of AD progression in patients with LB pathology.

Department of Health Sciences Research Mayo Clinic Rochester MN USA

Department of Neurology Mayo Clinic Rochester MN USA

Department of Neuroscience Mayo Clinic Jacksonville FL USA

Department of Neuroscience Mayo Clinic Jacksonville FL USA; Neuropathology Laboratory Mayo Clinic Jacksonville FL USA

Department of Pathology and Laboratory Medicine Mayo Clinic Rochester MN USA

Department of Psychiatry and Psychology Mayo Clinic Jacksonville FL USA

Department of Psychiatry and Psychology Mayo Clinic Rochester MN USA

Department of Psychiatry and Psychology Mayo Clinic Scottsdale AZ USA; Department of Neurology Mayo Clinic Scottsdale AZ USA

Department of Radiology Mayo Clinic Rochester MN USA

Department of Radiology Mayo Clinic Rochester MN USA; Department of Neurology 2nd Faculty of Medicine and Motol University Hospital Charles University Prague Prague the Czech Republic; International Clinical Research Center St Anne's University Hospital Brno Brno the Czech Republic

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