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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

doi: 10.1097/MNM.0b013e3283599983
Original Articles

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.

Departments of aNuclear Medicine

bRadiology

cNeurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece

dDepartment of Neurology, Memory and Cognitive Disorders Clinic, “G. Gennimatas” Hospital

eDepartment of Nuclear Medicine, “Alexandra” University Hospital, Athens, Greece

Correspondence to Varvara Valotassiou, MD, Department of Nuclear Medicine, University Hospital of Larissa, Mezourlo, 41110 Larissa, Greece Tel: +30 241 350 2916; fax: +30 241 350 1863; e-mails: valotasiou@med.uth.gr, vvalotasiou@gmail.com

Received May 10, 2012

Accepted August 22, 2012

© 2012 Lippincott Williams & Wilkins, Inc.