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On the role of quantitative brain imaging in the differential diagnosis of speech disorders
Author(s) -
Elst Ludger H. Tebartz Van,
Juengling Freimut D,
Kassubek Jan,
Schmidtke Klaus,
Thiel Thorsten,
Ebert Dieter,
Dykierek Petra,
Hüll Michael
Publication year - 2002
Publication title -
psychiatry and clinical neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 74
eISSN - 1440-1819
pISSN - 1323-1316
DOI - 10.1046/j.1440-1819.2002.00938.x
Subject(s) - neuroimaging , magnetic resonance imaging , psychogenic disease , positron emission tomography , psychology , differential diagnosis , neuropsychology , medicine , neuroscience , pathology , radiology , cognition
We present the case of a 71‐year‐old woman with an 11‐year history of slowly progressive decline of motor speech. Normal clinical investigations including routine magnetic resonance imaging (MRI) at 7, 8 and 10 years after the onset of speech dysfunction led to the suggestion of a psychogenic disorder. Extensive clinical, neuropsychological and neuroimaging investigations including 18 F‐desoxyglucose‐positron emission tomography (PET), quantitative MRI and MR spectroscopy were performed to look for subtle brain pathology. Quantitative assessment of 3D‐MRI, F‐desoxyglucose‐PET and magnetic resonance spectroscopy all demonstrated clear evidence of multifocal frontotemporal brain pathology that had not been picked up on routine MRI investigations on previous admissions. This is the longest benign history of slowly progressive anarthria reported so far. It demonstrates a possible role of quantitative neuroimaging techniques in the diagnosis of complex neuropsychiatric disorders.