Clinical Diagnosis of Frontal Lobe Dementia and Alzheimer’s Disease Relation to Cerebral Perfusion, Brain Atrophy and Electroencephalography

Julin, Per; Wahlund, Lars‐Olof; Basun, Hans; Persson, A.; Måre, Klas; Rudberg, Ulf

doi:10.1159/000106937

Cited by 23 publications

(24 citation statements)

References 13 publications

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“…[24][25][26] In contrast, we did not find brain regions in FTD that had lower perfusion than in AD, even after PVE correction. There could be several reasons for the discrepancy between this study and previous studies.…”

Section: Discussionmentioning

confidence: 72%

Hypoperfusion in frontotemporal dementia and Alzheimer disease by arterial spin labeling MRI

Du¹,

Jahng²,

Hayasaka³

et al. 2006

Neurology

259

192

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Objectives-To test if arterial spin labeling (ASL) MRI could detect a pattern of hypoperfusion in frontotemporal dementia (FTD) vs cognitively normal (CN) control subjects; to determine the regional difference of perfusion between FTD and Alzheimer disease (AD); and to determine whether hypoperfusion in FTD correlates with cognitive impairment.Methods-We included 21 patients with FTD, 24 patients with AD, and 25 CN subjects in this cross-sectional MRI study. All subjects had MRI scans including T1-weighted structural images and ASL-MR images.Results-ASL-MRI detected a pattern of hypoperfusion in right frontal regions in patients with FTD vs CN subjects, similar to PET and SPECT. FTD had higher perfusion than AD in the parietal regions and posterior cingulate. Frontal hypoperfusion in FTD correlated with deficits in judgment and problem solving. Adding frontal perfusion to gray matter (GM) atrophy significantly improved the classification of FTD from normal aging to 74%, and adding parietal perfusion to GM atrophy significantly improved the classification of FTD from AD to 75%. Combining frontal and parietal lobe perfusion further improved the classification of FTD from AD to 87%. Conclusion-Frontotemporal dementia andAlzheimer disease display different spatial distributions of hypoperfusion on arterial spin labeling MRI. With further development and evaluation, arterial spin labeling MRI could contribute to the differential diagnosis between frontotemporal dementia and Alzheimer disease.Frontotemporal dementia (FTD) and Alzheimer disease (AD) can be difficult to clinically differentiate because of overlapping symptoms. 1-3 Structural MRI can assess regional patterns of brain pathology and may aid a differential diagnosis between FTD and AD. 4-10 However, overlapping of brain tissue loss limits structural MRI to achieve complete separation between FTD and AD. Functional neuroimaging, yielding complementary information to tissue loss, may help the differentiation between FTD and AD. Previous PET and SPECT studies have shown different patterns of metabolism and perfusion reduction in FTD and AD. 11-26 However, PET and SPECT have several disadvantages, including injection of radioactive tracers and limited availability in comparison with MRI scanners. Arterial spin labeled

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Section: Discussionmentioning

confidence: 72%

Hypoperfusion in frontotemporal dementia and Alzheimer disease by arterial spin labeling MRI

Du¹,

Jahng²,

Hayasaka³

et al. 2006

Neurology

259

192

View full text Add to dashboard Cite

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“…AD patients were characterized by higher delta (0 -3 Hz), higher theta (4 -7 Hz), lower posterior alpha (8 -12 Hz), slowing in alpha peak frequency, and lower beta (14 -30 Hz) and gamma (around 40 Hz) (Dierks et al, 1993Huang et al, 2000;Wolf et al, 2003;Babiloni et al, 2004;Moretti et al, 2004;Adeli and GhoshDastidar, 2005). The abnormality of EEG rhythms in dementia has been associated with altered rCBF/metabolism and cognitive function (Szelies et al, 1992;Julin et al, 1995;Passero et al, 1995;Sloan et al, 1995;Rodriguez et al, 1999aRodriguez et al, , 1999b. Furthermore, parieto-temporal EEG rhythms and rCBF have been correlated with severity of AD as measured by Mini Mental State Evaluation scores (MMSE).…”

Section: Introductionmentioning

confidence: 99%

Donepezil effects on sources of cortical rhythms in mild Alzheimer's disease: Responders vs. Non-Responders

Cassetta²,

et al. 2006

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“…Therefore, this ratio is suggested to be of benefit in differential diagnosis. The ratio reflects a hypofrontal flow pattern in FTD, which has been described in previous studies [12][13][14][15][16][17]41]. However, fewer patients were included in these studies and other methods were sometimes used, e.g.…”

Section: Discussionmentioning

confidence: 90%

Frontotemporal Dementia Can Be Distinguished from Alzheimer’s Disease and Subcortical White Matter Dementia by an Anterior-to-Posterior rCBF-SPET Ratio

Sjögren

Gustafson

Wikkelsø

et al. 2000

Dement Geriatr Cogn Disord

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Sixteen patients with frontotemporal dementia (FTD), 27 with early-onset Alzheimer’s disease, 25 with late-onset Alzheimer’s disease, 19 with subcortical white matter dementia (SWD) and 28 normal controls underwent semiquantitative regional cerebral blood flow measurement (rCBF) using single-photon emission tomography (SPET; ^99mTc-HMPAO) and either computerized tomography (CT) or magnetic resonance imaging (MRI) of the brain. An anterior-to-posterior rCBF-SPET ratio (mesial superior frontal gyrus/medial temporal lobes) was calculated, which significantly separated the FTD group from the other dementia groups and controls with a sensitivity of 87.5% and a specificity of at least 78.6%. CT/MRI was found to be helpful in the differential diagnosis between FTD and SWD. In FTD patients, the mesial superior frontal gyrus, near the polus frontalis, was found to be the region with the most reduced rCBF values.

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Clinical Diagnosis of Frontal Lobe Dementia and Alzheimer’s Disease Relation to Cerebral Perfusion, Brain Atrophy and Electroencephalography

Cited by 23 publications

References 13 publications

Hypoperfusion in frontotemporal dementia and Alzheimer disease by arterial spin labeling MRI

Hypoperfusion in frontotemporal dementia and Alzheimer disease by arterial spin labeling MRI

Donepezil effects on sources of cortical rhythms in mild Alzheimer's disease: Responders vs. Non-Responders

Frontotemporal Dementia Can Be Distinguished from Alzheimer’s Disease and Subcortical White Matter Dementia by an Anterior-to-Posterior rCBF-SPET Ratio

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