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Nuclear Medicine Communications:
doi: 10.1097/MNM.0b013e3283599983
Original Articles

Perfusion SPECT studies with mapping of Brodmann areas in differentiating Alzheimer’s disease from frontotemporal degeneration syndromes

Valotassiou, Varvaraa; Papatriantafyllou, Johnd; Sifakis, Nikolaose; Tzavara, Charaa; Tsougos, Ioannisa; Kapsalaki, Eftychiab; Hadjigeorgiou, Georgec; Georgoulias, Panagiotisa

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Abstract

Objectives: The aim of this study was to evaluate the contribution of brain perfusion single-photon emission computed tomography (SPECT) studies with mapping of Brodmann areas (BAs) in the differential diagnosis between Alzheimer’s disease (AD) and frontotemporal degeneration (FTLD) syndromes.

Methods: Thirty-nine patients with AD and 73 patients with FTLD syndromes [behavioural variant FTLD (bvFTLD); language variant FTLD (lvFTLD), including semantic dementia (SD) and progressive nonfluent aphasia (PNFA); and corticobasal degeneration (CBD)/progressive supranuclear palsy (PSP) syndromes] underwent brain perfusion SPECT. The NeuroGam software was used for the semiquantitative evaluation of perfusion in BAs of the left (L) and right (R) hemispheres.

Results: Compared with those in AD patients, BAs with statistically significant hypoperfusion were found in the prefrontal, orbitofrontal and cingulated cortices and Broca’s areas of FTLD and bvFTLD patients; in the temporal and prefrontal cortices and Broca’s areas of lvFTLD patients; in the left temporal gyrus of SD patients; in premotor and supplementary motor, prefrontal, orbitofrontal, temporal and anterior cingulated cortices and Broca’s areas of PNFA patients; and in the prefrontal, temporal, posterior cingulated and primary and secondary visual cortices of CBD/PSP patients. BA 46R could differentiate AD patients from FTLD and bvFTLD patients; 21L and 25L were found to be independent predictors for lvFTLD in comparison with AD, and 25R, 21L and 23R could differentiate AD patients from PNFA, SD and CBD/PSP patients, respectively.

Conclusion: Brain perfusion SPECT with BA mapping in AD and FTLD patients could improve the definition of brain areas that are specifically implicated in these disorders, resulting in a more accurate differential diagnosis.

© 2012 Lippincott Williams & Wilkins, Inc.

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