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Frontotemporal atrophy associated with paranoid delusions in women with Alzheimer's disease

Published online by Cambridge University Press:  11 July 2011

D. Whitehead ,
C. Tunnard ,
C. Hurt ,
L. O. Wahlund ,
P. Mecocci ,
M. Tsolaki ,
B. Vellas ,
C. Spenger ,
I. Kłoszewska  and
H. Soininen
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D. Whitehead*
Affiliation:
MRC Centre for Neurodegeneration Research, King's College London, Institute of Psychiatry, UK Department of Psychology, King's College London, UK
C. Tunnard
Affiliation:
MRC Centre for Neurodegeneration Research, King's College London, Institute of Psychiatry, UK
C. Hurt
Affiliation:
Department of Psychology, King's College London, UK
L. O. Wahlund
Affiliation:
Department of Neurobiology, Care Sciences and Society, Section of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
P. Mecocci
Affiliation:
Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
M. Tsolaki
Affiliation:
Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
B. Vellas
Affiliation:
Toulouse Gerontopole University Hospital, Université Paul Sabatier, INSERM U 558, Toulouse, France
C. Spenger
Affiliation:
Department of Clinical Science, Intervention and Technology. Section of Radiology, Karolinska Institutet, Stockholm, Sweden
I. Kłoszewska
Affiliation:
Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Lodz, Poland
H. Soininen
Affiliation:
Department of Neurology, University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
D. Cromb
Affiliation:
Department of Neuroimaging Sciences, King's College London, Institute of Psychiatry, London, UK NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and King's College London, UK
S. Lovestone
Affiliation:
MRC Centre for Neurodegeneration Research, King's College London, Institute of Psychiatry, UK NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and King's College London, UK
A. Simmons
Affiliation:
MRC Centre for Neurodegeneration Research, King's College London, Institute of Psychiatry, UK Department of Neuroimaging Sciences, King's College London, Institute of Psychiatry, London, UK NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and King's College London, UK
*
Correspondence should be addressed to: Dr Daisy Whitehead, Ormond House, Institute of Neurology, 26–27 Boswell St, London, WC1N 3JZ, UK. Phone: +44 207 692 2616 ext. 4054. Email: d.whitehead@ion.ucl.ac.uk.
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Abstract

Background: Paranoid delusions are a common and difficult-to-manage feature of Alzheimer's disease (AD). We investigated the neuroanatomical correlates of paranoid delusions in a cohort of AD patients, using magnetic resonance imaging (MRI) to measure regional volume and regional cortical thickness.

Methods: 113 participants with probable AD were assessed for severity of disease, cognitive and functional impairment. Presence and type of delusions were assessed using the Neuropsychiatric Inventory (NPI). Structural MRI images were acquired on a 1.5T scanner, and were analyzed using an automated analysis pipeline.

Results: Paranoid delusions were experienced by 23 (20.4%) of the participants. Female participants with paranoid delusions showed reduced cortical thickness in left medial orbitofrontal and left superior temporal regions, independently of cognitive decline. Male participants with delusions did not show any significant differences compared to males without delusions. An exploratory whole brain analysis of non-hypothesized regions showed reduced cortical thickness in the left insula for female participants only.

Conclusion: Frontotemporal atrophy is associated with paranoid delusions in females with AD. Evidence of sex differences in the neuroanatomical correlates of delusions as well as differences in regional involvement in different types of delusions may be informative in guiding management and treatment of delusions in AD.

Keywords

Alzheimer's diseaseimagingpsychosissex differences
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 1 , January 2012 , pp. 99 - 107
Copyright
Copyright © International Psychogeriatric Association 2011

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