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7210797 
Journal Article 
Longitudinal Diffusion Tensor Imaging in Frontotemporal Dementia 
Mahoney, CJ; Schott, JM; Zhang, Hui; Ourselin, S; Warren, JD; Fox, NC; Simpson, IJA; Nicholas, JM; Fletcher, PD; Downey, LE; Golden, HL; Clark, CN; Schmitz, N; Rohrer, JD; , 
2015 
Yes 
Annals of Neurology
ISSN: 0364-5134
EISSN: 1531-8249 
WILEY 
HOBOKEN 
33-46 
25363208 
WOS:000348423200005 
ObjectiveNovel biomarkers for monitoring progression in neurodegenerative conditions are needed. Measurement of microstructural changes in white matter (WM) using diffusion tensor imaging (DTI) may be a useful outcome measure. Here we report trajectories of WM change using serial DTI in a cohort with behavioral variant frontotemporal dementia (bvFTD).MethodsTwenty-three patients with bvFTD (12 having genetic mutations), and 18 age-matched control participants were assessed using DTI and neuropsychological batteries at baseline and approximate to 1.3 years later. Baseline and follow-up DTI scans were registered using a groupwise approach. Annualized rates of change for DTI metrics, neuropsychological measures, and whole brain volume were calculated. DTI metric performances were compared, and sample sizes for potential clinical trials were calculated.ResultsIn the bvFTD group as a whole, rates of change in fractional anisotropy (FA) and mean diffusivity (MD) within the right paracallosal cingulum were greatest (FA: -6.8%/yr, p<0.001; MD: 2.9%/yr, p=0.01). MAPT carriers had the greatest change within left uncinate fasciculus (FA: -7.9%/yr, p<0.001; MD: 10.9%/yr, p<0.001); sporadic bvFTD and C9ORF72 carriers had the greatest change within right paracallosal cingulum (sporadic bvFTD, FA: -6.7%/yr, p<0.001; MD: 3.8%/yr, p=0.001; C9ORF72, FA: -6.8%/yr, p=0.004). Sample size estimates using FA change were substantially lower than neuropsychological or whole brain measures of change.InterpretationSerial DTI scans may be useful for measuring disease progression in bvFTD, with particular trajectories of WM damage emerging. Sample size calculations suggest that longitudinal DTI may be a useful biomarker in future clinical trials. ANN NEUROL 2015;77:33-46