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Analysis of Clinical and Neuroimaging Course of Four Patients with Left Side Dominant Fronto‐temporal Lobar Atrophy
Author(s) -
Katsuragi Toshio,
Saito Atsushi,
Iizuka Hiroshi,
Iseki Eizo,
Amano Naoji,
Kosaka Kenji
Publication year - 2002
Publication title -
psychogeriatrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.647
H-Index - 32
eISSN - 1479-8301
pISSN - 1346-3500
DOI - 10.1111/j.1479-8301.2002.tb00041.x
Subject(s) - neuroimaging , atrophy , temporal lobe , medicine , primary progressive aphasia , magnetic resonance imaging , cerebral atrophy , radiology , psychology , disease , pathology , epilepsy , dementia , psychiatry , frontotemporal dementia
Background : Patients with left side dominant fronto‐temporal lobar atrophy, as an example of primary progressive aphasia (PPA), are occasionally recognized. The concept of PPA is based on symptomatology. The aim of the present study was to investigate the clinical course and follow‐up neuroimaging in patients with left side dominant atrophy, especially, during the incipient stage. Methods : The subjects consist of four right‐handed patients showing left side dominant fronto‐temporal lobar atrophy on brain computed tomography or magnetic resonance imaging. They were analyzed using changes in clinical symptoms, electroencephalopathy (EEG), and neuroimaging course within a few years of diagnosis. Results : Three of four patients had symptoms of PPA incipiently. The neuroimaging of three patients revealed a reduction in the asymmetrical anterior temporal gyri including the hippocampus on the left and progressed to bilateral fronto‐temporal lobar atrophy within a few years. Conclusion : One patient was clinically diagnosed as having Pick's disease, and three patients had probable Alzheimer's disease (AD), based on the clinical course and the findings of EEG and brain neuroimaging including single photon emission computed tomography (SPECT). These results suggest the possibilities that the patients with PPA may eventually develop AD. Moreover we confirmed that patients with left side dominant atrophy may generally progress to bilateral fronto‐temporal lobar atrophy within a few years.