Document Detail


Semi-quantitative analysis of perfusion of Brodmann areas in the differential diagnosis of cognitive impairment in Alzheimer's disease, fronto-temporal dementia and mild cognitive impairment.
MedLine Citation:
PMID:  19675861     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Different perfusion defects reflect neurological damage characteristics of different kinds of dementia. Our aim was to investigate the role of brain single photon emission tomography (SPET) with semiquantitative analysis of Brodmann areas in dementia, by technetium-99m - hexamethyl-propylenamine- oxime ((99m)Tc-HMPAO) brain SPET with semiquantitative analysis of Brodmann areas in patients with Alzheimer's disease (AD), frontotemporal dementia (FTD) and mild cognitive impairment (MCI). We studied 75 patients, 25 with AD (NiNCDS ADRDA criteria), 25 with FTD (Lund and Manchester criteria), 25 with MCI (EADC criteria). After i.v. injection of 740MBq of (99m)Tc-HMPAO, each patient underwent brain SPET. A software application was used able to map the SPET brain image to a stereotaxic atlas (Talairach), providing an affine co-registration by blocks of data defined in the Talairach space. A normal database calculating voxel by voxel the mean and the standard deviation of the measured values was built. Functional SPET data of 3D regions of interest (ROI) of predefined Brodmann's area templates were compared with those of a database of healthy subjects of the same age and gender. Mean values obtained in the Brodmann area ROI in the different groups of patients studied were evaluated. Our results showed that different Brodmann areas were significantly impaired in the different categories of dementia subjects. Both areas 37 (temporal gyrus) and 39 (angular gyrus) of AD patients (mean+/-SD: 37L= -1.6+/-1.0; 37R= -1.5+/-1.1; 39L= -2.3+/-1.3; 39R= -1.9+/-1.2) showed significant hypoperfusion (P<0.05) versus MCI (37L= -0.9 +/-0.7; 37R= -1.1+/-0.9; 39L= -1.4+/-1.1; 39R= -1.6+/-1.6.) and FTD (37L= -1.1+/-0.8; 37R= -1.0+/-0.9; 39L= -1.4+/-1.0; 39R= -1.2+/-1.2) subjects. AD patients showed significantly (P<0.01) decreased perfusion in areas 40 (supramarginal gyrus) (40L= -2.6+/-1.0; 40R= -2.3+/-1.1) with respect to MCI patients (40L= -1.8+/-0.9; 40R= -1.7+/-1.2). Finally, FTD patients showed significant hypoperfusion (P<0.05) in both areas 47 (frontal association cortex) (47L= -1.8+/-0.8; 47R= -1.1+/-0.8) in comparison with MCI subjects (47L= -1.2+/-0.9; 47R= -0.9+/-0.9). In conclusion, our results suggest that semiquantitative analysis of single Brodmann areas identify frontal area hypoperfusion in FTD patients and also parietal and temporal impairment in AD patients. In MCI patients, no hypoperfusion pattern is identified.
Authors:
Cristina Tranfaglia; Barbara Palumbo; Donatella Siepi; Helmut Sinzinger; Lucilla Parnetti
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hellenic journal of nuclear medicine     Volume:  12     ISSN:  1790-5427     ISO Abbreviation:  Hell J Nucl Med     Publication Date:    2009 May-Aug
Date Detail:
Created Date:  2009-08-13     Completed Date:  2009-10-01     Revised Date:  2010-08-23    
Medline Journal Info:
Nlm Unique ID:  101257471     Medline TA:  Hell J Nucl Med     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  110-4     Citation Subset:  IM    
Affiliation:
Nuclear Medicine Section, Department of Surgical, Radiological and Odontostomatological Sciences, University of Perugia, Ospedale Santa Maria della Misericordia, Località S. Andrea delle Fratte i-06134, Perugia, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Alzheimer Disease / complications,  radionuclide imaging*
Cerebral Cortex / radionuclide imaging*
Cognition Disorders / complications,  radionuclide imaging*
Dementia / complications,  radionuclide imaging*
Diagnosis, Differential
Female
Humans
Image Enhancement / methods
Image Interpretation, Computer-Assisted / methods*
Male
Perfusion Imaging / methods*
Reproducibility of Results
Sensitivity and Specificity
Tomography, Emission-Computed, Single-Photon / methods*

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