Diseases with brain atrophy ?

IMO, the most important and interesting finding in the 202 and 201 studies is that 434 reduces the progression of brain atrophy ( Claassen's index). That means fewer brain cells are dying. I think that the reason why the cells die is very similar in all brain degenerative diseases: lack of energy.

I asked ChatGPT which diseases cause brain atrophy:

Which of the diseases causing dementia demonstrates brain atrophy?

ChatGPT told:

Brain atrophy is a common feature in several diseases that cause dementia. The pattern and severity of atrophy can help distinguish between different types of dementias. Here's a breakdown:

Diseases Causing Dementia with Brain Atrophy

1. Alzheimer’s Disease (AD)

• Atrophy Pattern:

  • Early and prominent in the hippocampus, entorhinal cortex, and medial temporal lobe.

  • Later spreads to the parietal lobes, posterior cingulate, and eventually more diffuse cortical thinning.

• Clinical Relevance:

  • The hallmark MRI finding is medial temporal lobe atrophy, strongly correlated with memory impairment.

2. Frontotemporal Dementia (FTD)

• Atrophy Pattern:

  • Marked atrophy in the frontal and anterior temporal lobes.

  • Often asymmetric (one hemisphere more affected).

• Subtypes:

  • Behavioral variant (bvFTD): frontal lobe predominant.

  • Semantic variant (svPPA): anterior temporal predominant.

  • Nonfluent variant (nfvPPA): left frontal and insular regions.

3. Lewy Body Dementia (LBD)

• Atrophy Pattern:

  • Usually less severe cortical atrophy than in AD.

  • Mild parietal and occipital atrophy may be seen, sometimes with preservation of the hippocampus.

• Note: MRI findings are less specific; functional imaging (DAT scan, FDG-PET) often more informative.

4. Vascular Dementia

• Atrophy Pattern:

  • Generalized or focal atrophy related to infarcts or chronic ischemic changes.

  • White matter hyperintensities, lacunar infarcts, and subcortical ischemic changes are common.

• Subtype:

  • Subcortical ischemic vascular dementia shows prominent white matter loss with secondary cortical thinning.

5. Parkinson’s Disease Dementia (PDD)

• Atrophy Pattern:

  • Usually mild cortical atrophy compared to AD.

  • Subcortical structures (basal ganglia) may show volume loss.

  • Atrophy is less pronounced but can progress with disease duration.

6. Huntington’s Disease Dementia

• Atrophy Pattern:

  • Early and severe caudate nucleus and putamen atrophy.

  • Leads to secondary cortical thinning in advanced stages.

7. Corticobasal Degeneration (CBD) & Progressive Supranuclear Palsy (PSP)

• Atrophy Pattern:

  • CBD: Asymmetric frontoparietal cortical and basal ganglia atrophy.

  • PSP: Midbrain atrophy (“hummingbird sign”), less cortical involvement early.

✅ Summary Table

	Dementia Type	Brain Atrophy Pattern
1	Alzheimer’s	Medial temporal → parietal → diffuse cortical
2	FTD	Frontal and anterior temporal, often asymmetric
3	Lewy Body	Mild, less than AD; occipital/parietal
4	Vascular	Focal/generalized atrophy from infarcts, white matter loss
5	Parkinson’s	Mild cortical; subcortical structures affected
6	Huntington’s	Caudate and putamen → cortical thinning
7	CBD/PSP	Frontal/parietal, basal ganglia, midbrain

It is a good possibility that ATH434 will improve ATP production in mitochondria in many other diseases than MSA.