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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 1.5 T 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.

Original publication

DOI

10.1017/S1041610211000974

Type

Journal article

Journal

Int Psychogeriatr

Publication Date

01/2012

Volume

24

Pages

99 - 107

Keywords

Aged, Alzheimer Disease, Atrophy, Delusions, Female, Frontal Lobe, Humans, Magnetic Resonance Imaging, Male, Neuroimaging, Neuropsychological Tests, Paranoid Disorders, Sex Factors, Temporal Lobe