AUTHOR=Hansen Niels , Müller Sebastian Johannes , Khadhraoui Eya , Riedel Christian Heiner , Langer Philip , Wiltfang Jens , Timäus Charles-Arnold , Bouter Caroline , Ernst Marielle , Lange Claudia 

TITLE=Metric magnetic resonance imaging analysis reveals pronounced substantia-innominata atrophy in dementia with Lewy bodies with a psychiatric onset

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=Volume 14 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2022.815813

DOI=10.3389/fnagi.2022.815813

ISSN=1663-4365

ABSTRACT=Background: Dementia with Lewy bodies (DLB) is a type of dementia often diagnosed in older patients. Since its initial symptoms range from delirium to psychiatric and cognitive symptoms, the diagnosis is often delayed. 
Objectives: In our study, we evaluated the magnetic resonance imaging (MRI) of patients suffering from DLB in correlation with their initial symptoms taking a new pragmatic approach entailing manual measurements in addition to an automated volumetric analysis of MRI. 
Methods: 63 patients with diagnosed DLB and valid 3D data sets were retrospectively and blinded evaluated. We assessed atrophy patterns 1) manually for the substantia innominata and 2) via FastSurfer for the most common supratentorial regions. Initial symptoms were categorized by (1) mild cognitive impairment (MCI), (2) psychiatric episodes, and (3) delirium.
Results: Manual metric MRI measurements revealed moderate, but significant substantia-innominata (SI) atrophy in patients with a psychiatric onset. Automatic volumetric MRI analysis failed to confirm those results.
Conclusions: The SI in patients with DLB and a psychiatric-onset is more atrophied than that in patients with initial mild cognitive impairment. Our work shows that the latest basic volumetric segmentation algorithm does not detect every kind of atrophy.