Multimodality imaging of neurodegenerative disorders with a focus on multiparametric magnetic resonance and molecular imaging

Loftus, James Ryan; Puri, Savita; Meyers, Steven P.

doi:10.1186/s13244-022-01358-6

Table 2 Synopsis of imaging features of common neurodegenerative disorders

From: Multimodality imaging of neurodegenerative disorders with a focus on multiparametric magnetic resonance and molecular imaging

	Typical AD	DLB	VaD	FTD
sMRI	Mesial temporal lobe atrophy	Frontotemporal atrophy	Two or more large territory, three or greater lacunar infarcts, or strategically placed infarcts. Involvement of cerebral hemisphere by greater than 25% WMHs	bv—Ventromedial prefrontal and insular cortical atrophy svPPA—left inferior temporal lobe including the insular gyrus nfPPA—posterior frontal, temporal, and parietal lobes
SW/T2*		Swallow tail sign	Microhemmorhages can be present
MRS	Decreased NAA/myoinsitol in the PCC
DTI	Decreased FA and increased MD in mesial temporal lobe, PCC, SLF	Decreased FA parieto-occipital lobes, PCC, striatum	Reduced FA and increased MD in the centrum semiovale and anterior periventricular white matter	Reduced FA in the UF, genu of the CC, and left ACC
rsfMRI	Hypoconnectivity of DMN	Hypoconnectivity of DMN and visual networks	Hypoconnectivity of DMN	Hypoconnectivity of salience network and disruption of frontoinsular and executive connections
ASL	Hypoperfusion involving the temporopartietal lobes			Hypoperfusion of the frontal lobes and anterior cingulate cortex
FDG-PET	Temporopartietal hypometabolism	Temporopartietal and occipital hypometabolism Cingulate island sign Occipital tunnel sign	Hypometabolism of the anterior cingulate cortex, deep gray nuclei, primary cortices, and middle temporal gyrus	bv—hypometabolism of ventromedial frontal lobe and anterior temporal lobes svPPA—hypometabolism of left or bilateral temporal poles, middle and inferior temporal gyri, and insula nfPPA—hypometabolism of the inferior temporal gyrus, anterior cingulate cortex, and insula with sparing of the amygdala and hippocampi
Amyloid PET	Often diffuse cortical uptake	Majority demonstrate uptake, primarily temporoparietal with more involvement of the occipital lobes compared to AD	At least 25% demonstrate uptake	Generally lack of uptake
Tau PET	Uptake within the temporopartietal neocortical areas—in vivo Braak staging	Inferolateral temporal and parietal lobes with less mesial temporal lobe activity compared to AD		Uptake in the inferior and lateral temporal lobes and temporal poles, and anterior cingulate cortex
DAT/Dopamine imaging		Decreased striatal uptake	Striatal infarcts can lead to decreased uptake

sMRI structural magnetic resonance imaging, MRS Magnetic resonance spectroscopy, DTI Diffusion tensor imaging, rsfMRI resting-state functional magnetic resonance imaging, ASL Arterial spin labeling, FDG Fluorodeoxyglucose, PET Positron emission tomography, DAT Dopamine transporter, AD Alzheimer’s disease, NAA N-acetylaspartate, FA Fractional anisotropy, MD Mean diffusivity, DMN Default mode network, PCC Posterior cingulate cortex, SLF Superior longitudinal fasciculus, DLB Dementia with Lewy bodies, VaD Vascular dementia, WMH White matter hyperintensity, FTD Frontotemporal dementia, bv behavioral variant, PPA Primary progressive aphasia, sv semantic variant, nf nonfluent, UF Uncinate fasciculus

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