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Distinct patterns of medial temporal impairment in degenerative dementia: a brain SPECT perfusion study in Alzheimer’s disease and frontotemporal dementia

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Medial temporal impairment can be detected clinically and by morphological imaging during Alzheimer’s disease (AD), but the existence of a functional impairment in this area seems to be less well established. Yet such functional impairment is classically found in other degenerative cortical dementias, such as the frontal variant of frontotemporal dementia (fv-FTD). The aim of this study was to characterize and compare brain SPECT perfusion of the medial temporal lobe in AD and fv-FTD.

Methods

Voxel-based comparisons were performed using SPM8 between cerebral SPECT images from 85 AD patients, 25 fv-FTD patients and 12 healthy controls at the whole-brain level and the medial temporal lobe level using a region of interest approach (p < 0.001, corrected for the cluster).

Results

In the free and cued selective reminding test, used to evaluate medial temporal memory function, AD patients had significantly lower scores than the fv-FTD patients (p < 0.005). AD and fv-FTD patients showed hypoperfused medial temporal structures in comparison to normal controls. However, fv-FTD patients had more pronounced hypoperfusion in this area, with a different topography, more anterior and more parahippocampal.

Conclusion

These results show that medial temporal hypoperfusion can be detected in degenerative dementias by SPECT. Paradoxically, the hypoperfusion is more severe in fv-FTD than in AD patients, even though the mnesic profile of AD is more altered, suggesting the existence of inefficient compensatory mechanisms.

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Conflicts of interest

None.

Funding

This work was funded by APHM (PHRC 2007/09).

Author information

Authors and Affiliations

  1. Service de Médecine Nucléaire, Hôpital d’Instruction des Armées Sainte Anne, 83800, Toulon Cedex 09, France

    Mathieu Basely

  2. Service de Neurologie et de Neuropsychologie, APHM, Hôpital de la Timone, Marseille, France

    Mathieu Ceccaldi

  3. UMR Inserm 1106, Institut de Neurosciences des Systèmes, Aix-Marseille Univ, 13005, Marseille, France

    Mathieu Ceccaldi

  4. EA 3279 - Self-perceived Health Assessment Research Unit, School of Medicine, La Timone University, 13005, Marseille, France

    Laurent Boyer

  5. Service Central de Biophysique et Médecine Nucléaire, APHM, Hôpital de la Timone, Pierre, 13385, Marseille Cedex 05, France

    Olivier Mundler & Eric Guedj

  6. CERIMED, Aix-Marseille Univ, Marseille, France

    Olivier Mundler & Eric Guedj

  7. Institut de Neurosciences de la Timone, CNRS UMR7289, Aix-Marseille Univ, 13005, Marseille, France

    Eric Guedj

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  1. Mathieu Basely
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Correspondence to Eric Guedj.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Online Resource 1

Talairach coordinates of significant cerebral cortical hypoperfusions (p < 0.001 for the voxel, uncorrected) in AD patients in comparison to the healthy subjects. Results from SPM8 are listed in decreasing order of peak T-score value, k values represent the number of significant voxels in the particular cluster. (DOCX 29 kb)

Online Resource 2

Talairach coordinates of significant cerebral cortical hypoperfusions (p < 0.001 for the voxel, uncorrected) in AD patients in comparison to the healthy subjects. Results from SPM8 are listed in decreasing order of peak T-score value, k values represent the number of significant voxels in the particular cluster. (DOCX 26 kb)

Online Resource 3

Talairach coordinates of significant cerebral cortical hypoperfusions (p < 0.001 for the voxel, uncorrected) in AD patients in comparison to the healthy subjects. Results from SPM8 are listed in decreasing order of peak T-score value, k values represent the number of significant voxels in the particular cluster. (DOCX 26 kb)

Online Resource 4

Talairach coordinates of significant cerebral cortical hypoperfusions (p < 0.001 for the voxel, uncorrected) in AD patients in comparison to the healthy subjects. Results from SPM8 are listed in decreasing order of peak T-score value, k values represent the number of significant voxels in the particular cluster. (DOCX 27 kb)

Online Resource 5

Talairach coordinates of significant cerebral cortical hypoperfusions (p < 0.001 for the voxel, uncorrected) in AD patients in comparison to the healthy subjects. Results from SPM8 are listed in decreasing order of peak T-score value, k values represent the number of significant voxels in the particular cluster. (DOCX 26 kb)

Online Resource 6

Talairach coordinates of significant cerebral cortical hypoperfusions (p < 0.001 for the voxel, uncorrected) in AD patients in comparison to the healthy subjects. Results from SPM8 are listed in decreasing order of peak T-score value, k values represent the number of significant voxels in the particular cluster. (DOCX 25 kb)

Online Resource 7

Talairach coordinates of significant cerebral cortical hypoperfusions (p < 0.001 for the voxel, uncorrected) in AD patients in comparison to the healthy subjects. Results from SPM8 are listed in decreasing order of peak T-score value, k values represent the number of significant voxels in the particular cluster. (DOCX 24 kb)

Online Resource 8

Talairach coordinates of significant cerebral cortical hypoperfusions (p < 0.001 for the voxel, uncorrected) in AD patients in comparison to the healthy subjects. Results from SPM8 are listed in decreasing order of peak T-score value, k values represent the number of significant voxels in the particular cluster. (DOCX 25 kb)

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Basely, M., Ceccaldi, M., Boyer, L. et al. Distinct patterns of medial temporal impairment in degenerative dementia: a brain SPECT perfusion study in Alzheimer’s disease and frontotemporal dementia. Eur J Nucl Med Mol Imaging 40, 932–942 (2013). https://doi.org/10.1007/s00259-013-2389-8

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  • DOI: https://doi.org/10.1007/s00259-013-2389-8

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