title: Brain reserve capacity in frontotemporal dementia: a voxel-based 18F-FDG PET study.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Ismaningerstr. 22, 81675 München, Germany. robert.perneczky@lrz.tum.de
authors.forename: Robert
authors.initials: R
authors.lastname: Perneczky
authors.forename: Janine
authors.initials: J
authors.lastname: Diehl-Schmid
authors.forename: Alexander
authors.initials: A
authors.lastname: Drzezga
authors.forename: Alexander
authors.initials: A
authors.lastname: Kurz
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism*; D003704:Dementia / Q000000981:diagnostic imaging* / Q000378:metabolism*; D004522:Educational Status; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose