Regional brain atrophy in progressive supranuclear palsy and Lewy body disease

There have been no previous three-dimensional volumetric studies of regiona l brain atrophy in patients with pathologically confirmed progressive supra nuclear palsy (PSP). Postmortem cortical and subcortical volumes were compa red with neuropathology in 9 patients with PSP, 15 patients with 'Parkinson 's disease, 10 patients with dementia with Lewy bodies, and 23 controls. Ca ses with the neuritic pathology of Alzheimer's disease were excluded. The t opography of brain atrophy differed according to clinicopathological phenot ype. Patients with Parkinson's disease had atrophy confined to the amygdala . Atrophy of the frontal lobe was found in both PSP and dementia with Lewy bodies and correlated with increasing neurofibrillary tangle or Lewy body d ensities, respectively. Patients with PSP could be differentiated by their marked atrophy of the internal globus pallidus. Further analysis of varianc e revealed that trends for greater frontal lobe atrophy correlated with cli nical dementia in PSP, whereas both greater frontal and hippocampal atrophy and higher densities of Lewy bodies and Lewy neurites correlated with clin ical dementia in cases with Lewy bodies, The present study provides evidenc e for selective regional atrophy that correlates with the underlying pathol ogy of PSP and Lewy body disease.