Hypoperfusion in frontotemporal dementia and Alzheimer disease by arterial spin labeling MRI.
OBJECTIVE
To test if arterial spin labeling (ASL) MRI could detect a pattern of hypoperfusion in frontotemporal dementia (FTD) vs cognitively normal (CN) control subjects; to determine the regional difference of perfusion between FTD and Alzheimer disease (AD); and to determine whether hypoperfusion in FTD correlates with cognitive impairment.


METHODS
We included 21 patients with FTD, 24 patients with AD, and 25 CN subjects in this cross-sectional MRI study. All subjects had MRI scans including T1-weighted structural images and ASL-MR images.


RESULTS
ASL-MRI detected a pattern of hypoperfusion in right frontal regions in patients with FTD vs CN subjects, similar to PET and SPECT. FTD had higher perfusion than AD in the parietal regions and posterior cingulate. Frontal hypoperfusion in FTD correlated with deficits in judgment and problem solving. Adding frontal perfusion to gray matter (GM) atrophy significantly improved the classification of FTD from normal aging to 74%, and adding parietal perfusion to GM atrophy significantly improved the classification of FTD from AD to 75%. Combining frontal and parietal lobe perfusion further improved the classification of FTD from AD to 87%.


CONCLUSIONS
Frontotemporal dementia and Alzheimer disease display different spatial distributions of hypoperfusion on arterial spin labeling MRI. With further development and evaluation, arterial spin labeling MRI could contribute to the differential diagnosis between frontotemporal dementia and Alzheimer disease.
Du
A T
AT
Center for Imaging of Neurodegenerative Diseases, Department of Veterans Affairs Medical Center, San Francisco, USA. Antao.Du@ucsf.edu
Jahng
G H
GH
Hayasaka
S
S
Kramer
J H
JH
Rosen
H J
HJ
Gorno-Tempini
M L
ML
Rankin
K P
KP
Miller
B L
BL
Weiner
M W
MW
Schuff
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis*; D002545:Brain Ischemia / Q000150:complications / Q000175:diagnosis*; D002536:Cerebral Arteries / Q000473:pathology*; D002560:Cerebrovascular Circulation; D003704:Dementia / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013113:Spin Labels
D013113:Spin Labels