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Brain reserve capacity in frontotemporal dementia: a voxel-based 18F-FDG PET study

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Abstract

Purpose

The association of the regional cerebral metabolic rate of glucose utilisation (rCMRglc) and years of schooling has been extensively studied in Alzheimer’s disease (AD). The results suggest that brain reserve capacity (BRC) allows patients with more years of schooling to cope better with AD pathology. The objective of this study was to provide initial evidence for BRC in frontotemporal dementia (FTD).

Methods

Twenty-nine patients with FTD and 16 healthy age- and education-matched controls underwent PET imaging of the brain with 18F-fluoro-2-deoxy-glucose. A group comparison of rCMRglc was conducted between patients and controls and the output was saved as region of interest (ROI). A linear regression analysis with education as the independent and rCMRglc as the dependent variable, adjusted for age, gender and total score on the CERAD neuropsychological battery, was conducted in SPM2 over the pre-assigned ROI.

Results

Patients showed a reduced rCMRglc in almost the entire prefrontal cortex and the anterior cingulate cortex as compared with controls (p < 0.05 corrected for multiple comparisons). The regression analysis revealed a significant negative association between years of schooling and rCMRglc in the bilateral inferior frontal cortex (p < 0.001, uncorrected for multiple comparisons), which was independent of demographic variables and cognitive performance level. There was a strong negative correlation of rCMRglc and education (r = −0.45).

Conclusion

The study provides initial evidence for BRC in FTD. The findings suggest that interindividual differences in educational level affect BRC by partially mediating the relationship between neurodegeneration and the clinical manifestation of FTD.

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Acknowledgements

This study was partly funded by the Federal Ministry of Research and Education as part of a national collaboration on dementia (Kompetenznetz Demenzen), grant N° 01GI0420 and the Komission für Klinische Forschung, Klinikum rechts der Isar, München, grant N° 8765. The sponsors played no role in the design and conduct of the study; the collection, management, analysis and interpretation of the data; or the preparation, review and approval of the manuscript. The authors do not report any conflicts of interest.

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Authors and Affiliations

  1. Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Ismaningerstr. 22, 81675, München, Germany

    Robert Perneczky, Janine Diehl-Schmid & Alexander Kurz

  2. Nuklearmedizinische Klinik, Technische Universität München, Ismaningerstr. 22, 81675, München, Germany

    Alexander Drzezga

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  1. Robert Perneczky
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  2. Janine Diehl-Schmid
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  3. Alexander Drzezga
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  4. Alexander Kurz
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Correspondence to Robert Perneczky.

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Perneczky, R., Diehl-Schmid, J., Drzezga, A. et al. Brain reserve capacity in frontotemporal dementia: a voxel-based 18F-FDG PET study. Eur J Nucl Med Mol Imaging 34, 1082–1087 (2007). https://doi.org/10.1007/s00259-006-0323-z

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  • DOI: https://doi.org/10.1007/s00259-006-0323-z

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