Background/Aims: The clinical syndrome of the frontotemporal dementias (FTD) overlaps with frontal-subcortical circuit syndromes. We explored the extent to which subcortical atrophy on structural magnetic resonance imaging may indicate a subcortical contribution to the progression of FTD. Methods: This cross-sectional case-control study compared striatal and thalamic gray matter volumes and functional levels from 30 FTD cases and 30 age- and gender-matched controls. Results: The FTD group had significantly more atrophy in all gray matter subcortical regions, correlating with ipsilateral frontocortical atrophy. Subcortical atrophy was also associated with functional disability. Subcortical asymmetry was most marked in subjects with primary progressive aphasia. Conclusion: Subcortical gray matter atrophy may contribute as significantly to symptoms of FTD as cortical atrophy.

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