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P1‐098: β‐amyloid plaques in a PiB‐PET negative subject: Implications for sensitivity of amyloid imaging in vivo
Author(s) -
Ikonomovic Milos D.,
Abrahamson Eric E.,
Hamilton Ronald L.,
Mathis Chester A.,
Price Julie,
Mizukami Katsuyoshi,
Saxton Judith A.,
Lopez Oscar L.,
DeKosky Steven T.,
Klunk William E.
Publication year - 2009
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2009.04.102
Subject(s) - pathology , senile plaques , pittsburgh compound b , amyloid (mycology) , dementia with lewy bodies , neocortex , immunohistochemistry , dementia , alzheimer's disease , positron emission tomography , chemistry , medicine , psychology , nuclear medicine , neuroscience , disease
version. Follow-up language evaluation, MR imaging, and PET study were performed. Subtraction between the initial and follow-up PET images was performed to evaluate changes in glucose metabolism. Results: Initial language test revealed Wernicke’s aphasia; impaired comprehension (29 percentile), repetition (37 percentile), naming (31 percentile), and spared fluency (91 percentile). The MR imaging showed acute infarction involving the pars triangualris and pars opercularis without Wernicke’s area lesion. The PET revealed decreased metabolism in the left side superior temporal gyrus and angular gyrus as well as the prefrontal language area including the Broca’s area. The Wernicke’s aphasia of the patient slowly improved over twelve months. The subtraction between the initial and follow-up PET images showed increased glucose metabolism in the left side frontal and parietal lobe. The follow-up MR imaging showed infarction restricted to the previous frontal lobe region. Conclusions: This report demonstrated Wernicke’s aphasia after infarction restricted to the left frontal lobe with additional hypometabolism in the left temporo-parietal lobe. The preserved fluency may be attributed to the sparing of the posterior precentral gyrus. While, the comprehension deficit could be caused by decreased metabolism in the Wernicke’s area, implying the disconnection of the Broca’s area from the Wernicke’s area. The increased metabolism in the both area with clinical improvement may also support the connection between the motor and sensory language areas.