Neurobiology of Aging 28 (2007) 20–28 Atrophy rates of the cingulate gyrus and hippocampus in AD and FTLD Josephine Barnes a,∗ , Alison K. Godbolt a , Chris Frost a,b , Richard G. Boyes a , Bethany F. Jones d , Rachael I. Scahill a , Martin N. Rossor a,c,e , Nick C. Fox a,c a Dementia Research Centre, University College London, Institute of Neurology, Queen Square, London, UK b Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, UK c Department of Clinical Neurology, National Hospital for Neurology and Neurosurgery, Queen, Square, London, UK d Department of Neurology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands e Division of Neuroscience and Mental Health, Faculty of Medicine, Imperial College of Science, Engineering and Medicine, London, UK Received 24 May 2005; received in revised form 21 October 2005; accepted 21 November 2005 Available online 6 January 2006 Abstract This study explores the diagnostic utility of atrophy rates of the cingulate gyrus, its subdivisions and the hippocampus in Alzheimer’s disease (AD) and frontotemporal lobar degeneration (FTLD). Regions were manually outlined on MR images of a group of pathologically or genetically confirmed patients with AD (n = 19), FTLD (n = 8) and age-matched controls (n = 11). Mean (S.D.) atrophy rates (% year -1 ) in the cingulate in controls, AD and FTLD were -0.3 (1.2), 5.9 (3.5), and 8.6 (4.1), respectively. Hippocampal atrophy rates in controls, AD and FTLD were -0.1 (0.8), 3.4 (2.2), and 5.2 (5.4), respectively. Atrophy rates were significantly higher in the cingulate and hippocampi in AD and FTLD compared with controls (p < 0.01). There was evidence of a difference in trends of atrophy in the cingulate (more anterior in FTLD and more posterior in AD) between the disease groups (p = 0.03). Cingulate atrophy rates discriminated perfectly between FTLD and controls. Significantly better discrimination between AD and controls was obtained by hippocampal rather than cingulate rates. In conclusion, cingulate atrophy is as significant a feature of AD and FTLD as hippocampal atrophy. © 2005 Elsevier Inc. All rights reserved. Keywords: Cingulate; Hippocampus; Atrophy; Alzheimer’s disease (AD); Frontotemporal lobar degeneration (FTLD); MR; Longitudinal 1. Introduction Alzheimer’s disease (AD) is the most common form of dementia worldwide, affecting over 20% of the population over 80 years of age [14]. AD is characterized by neuronal loss and the presence of neurofibrillary tangles and amyloid plaques in the brain. A definitive diagnosis requires histo- logical examination, usually at post mortem. In the earliest stages of the disease, neurofibrillary tangles are thought to be focussed in the entorhinal cortex and hippocampus, progress- ing to involve other limbic structures including the cingulate ∗ Corresponding author at: Dementia Research Centre, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK. Tel.: +44 20 7829 8773; fax: +44 20 7676 2066. E-mail address: j.barnes@dementia.ion.ucl.ac.uk (J. Barnes). gyrus and eventually being widely distributed throughout the cortex [4,5]. Frontotemporal lobar degeneration (FTLD) is the second most common form of dementia in persons under 65 after AD [46]. FTLD is characterised by focal frontal and/or temporal atrophy associated with a number of histopathological features, which include tau positive or ubiquitin positive inclusions or may lack distinguishing hall- marks. Magnetic resonance imaging (MRI) allows in vivo assess- ment of the macroscopic effects of these pathologies, namely brain atrophy. In AD cross-sectional volumetric MRI stud- ies of the cingulate gyrus have revealed significantly lower cingulate volumes compared with controls [6,33]. This con- curs with voxel-based morphometric (VBM) data, which also reveals reduced grey matter density in the cingulate gyrus in AD, more specifically in the posterior region [2,23,47]. 0197-4580/$ – see front matter © 2005 Elsevier Inc. All rights reserved. doi:10.1016/j.neurobiolaging.2005.11.012