Michael C Woodward1, Christopher C Rowe2, Gareth Jones3, Victor L Villemagne3, Tammie A Varos4. 1. Austin Health Continuing Care Clinical Service Unit, Heidelberg, Victoria, Australia University of Melbourne, Melbourne, Victoria, Australia. 2. Austin Health Continuing Care Clinical Service Unit, Heidelberg, Victoria, Australia Austin Health Centre for PET, Heidelberg, Victoria, Australia. 3. University of Melbourne, Melbourne, Victoria, Australia Austin Health Centre for PET, Heidelberg, Victoria, Australia. 4. Monash University, Monash, Victoria, Australia.
Abstract
BACKGROUND: Alzheimer's disease (AD) can present with behavioral changes with this syndrome described as frontal variant AD (FvAD). Excess frontal pathology may explain this presentation. Neuroimaging with fluoro-deoxy-glucose positron emission tomography (FDG- PET) can be used to examine the effects of pathology in FvAD. METHODS: We administered an assessment scale for frontal behavioral impairment, the Frontal Behavioral Inventory (FBI), to 53 patients with AD. Scores in the top quartile were defined as FvAD. FDG- PET was analyzed in 8 frontal regions. RESULTS: The Z (SD) score for metabolism was significantly higher (indicating greater hypometabolism) in the FvAD group than the remaining AD group for combined left and right orbitofrontal regions (2.64 (SD 0.99) versus 2.11 (1.22), p < 0.03)) and combined left and right medial frontal regions (2.38 (0.63) versus 1.82 (0.88) p < 0.003) but insignificantly different in combined lateral frontal and superior frontal regions. Statistical parametric mapping revealed these frontal regions to be the only brain regions with significantly different metabolism between the FvAD and the remainder of the AD groups. CONCLUSIONS: Medial and orbital frontal hypometabolism is greater in AD patients presenting with more frontal/behavioral features, likely reflecting a greater pathological load in these brain regions in FvAD patients. These frontal regions may be more linked to behavioral features than other frontal brain regions.
BACKGROUND:Alzheimer's disease (AD) can present with behavioral changes with this syndrome described as frontal variant AD (FvAD). Excess frontal pathology may explain this presentation. Neuroimaging with fluoro-deoxy-glucose positron emission tomography (FDG- PET) can be used to examine the effects of pathology in FvAD. METHODS: We administered an assessment scale for frontal behavioral impairment, the Frontal Behavioral Inventory (FBI), to 53 patients with AD. Scores in the top quartile were defined as FvAD. FDG- PET was analyzed in 8 frontal regions. RESULTS: The Z (SD) score for metabolism was significantly higher (indicating greater hypometabolism) in the FvAD group than the remaining AD group for combined left and right orbitofrontal regions (2.64 (SD 0.99) versus 2.11 (1.22), p < 0.03)) and combined left and right medial frontal regions (2.38 (0.63) versus 1.82 (0.88) p < 0.003) but insignificantly different in combined lateral frontal and superior frontal regions. Statistical parametric mapping revealed these frontal regions to be the only brain regions with significantly different metabolism between the FvAD and the remainder of the AD groups. CONCLUSIONS: Medial and orbital frontal hypometabolism is greater in ADpatients presenting with more frontal/behavioral features, likely reflecting a greater pathological load in these brain regions in FvADpatients. These frontal regions may be more linked to behavioral features than other frontal brain regions.
Entities:
Keywords:
Alzheimer's disease; FDG- PET; Frontal Behavioral Inventory; behavioral features versus hypometabolism; degree of hypometabolism; frontal variant Alzheimer's disease; statistical parametric mapping
Authors: Adam M Staffaroni; Fanny M Elahi; Dana McDermott; Kacey Marton; Elissaios Karageorgiou; Simone Sacco; Matteo Paoletti; Eduardo Caverzasi; Christopher P Hess; Howard J Rosen; Michael D Geschwind Journal: Semin Neurol Date: 2017-12-05 Impact factor: 3.420
Authors: Rik Ossenkoppele; Yolande A L Pijnenburg; David C Perry; Brendan I Cohn-Sheehy; Nienke M E Scheltens; Jacob W Vogel; Joel H Kramer; Annelies E van der Vlies; Renaud La Joie; Howard J Rosen; Wiesje M van der Flier; Lea T Grinberg; Annemieke J Rozemuller; Eric J Huang; Bart N M van Berckel; Bruce L Miller; Frederik Barkhof; William J Jagust; Philip Scheltens; William W Seeley; Gil D Rabinovici Journal: Brain Date: 2015-07-02 Impact factor: 13.501