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P2–090: Hippocampal deformity in nonsemantic primary progressive aphasia
Author(s) -
Christensen Adam,
Alpert Kathryn,
Rogalski Emily,
Cobia Derin,
Weintraub Sandra,
Mesulam Marsel,
Wang Lei
Publication year - 2013
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.2013.05.733
Subject(s) - primary progressive aphasia , subiculum , hippocampal formation , aphasia , psychology , dementia , audiology , lateralization of brain function , hippocampus , neuroscience , medicine , frontotemporal dementia , pathology , disease , dentate gyrus
Lewy bodies (DLB), core features and several non-motor symptoms of Parkinson disease (PD) frequently precede cognitive impairment. F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) and I-123 iodoamphetamine (IMP) single photon emission computed tomography (SPECT) are helpful for the differential diagnosis of AD and DLB. But it is little known about imaging differential diagnosis among mild cognitive impairment (MCI) patients.Methods:We constructed the normal databases of FDG-PET and IMP-SPECT. By using the database we examined 9 AD patients, 9 DLB patients, 8 prodromal AD patients who converted to AD within 3 years, and 9 mild DLB patients with some core features of DLB and/or non-motor symptoms of PD. Then the regional uptake reductions of FDG/IMP were calculated by NEUROSTAT. Results: In AD and DLB patients, receiver operatorating characteristic analysis of lateral and medial occipital regions (l-OR and m-OR) using either FDG-PET or IMP-SPECT was useful to distinguish AD and DLB. We defined the cut-off points of maximum FDG/IMP uptake reductions of AD in the l-OR and m-OR, respectively, and examined the prevalence of FDG/IMP uptake reduction in the l-OR or m-OR of prodromal AD and mild DLB patients. Regarding FDG-PET, the prevalence of uptake reduction in both the l-OR and m-OR was significantly higher in mild DLB patients than in prodromal AD patients. (l-OR: prodromal AD 12.5% vs mild DLB 66.7%, P<0.05, m-OR: prodromal AD 12.5% vs mild DLB 77.8%, P<0.05). Regarding IMPSPECT, the prevalence of uptake reduction in the m-OR was significantly higher in mild DLB patients than in prodromal AD patients (prodromal AD 0% vs mild DLB 66.7%, P<0.05), but not in the l-OR (prodromal AD 12.5% vs mild DLB 55.6%). Conclusions: Both FDG-PET and IMPSPECT are useful for differential diagnosis between AD and DLB. For differential diagnosis of MCI patients with AD and DLB, FDG-PET may be more useful than IMP-SPECT.