Correlative studies of structural and functional imaging in primary progressive aphasia.
BACKGROUND
To compare and contrast structural and functional imaging in primary progressive aphasia (PPA).


METHODS
A cohort of 8 patients diagnosed with PPA presenting with nonfluency were prospectively evaluated. All patients had structural imaging in the form of MRI and in 1 patient CAT scanning on account of a cardiac pacemaker. All patients had single-photon emission computed tomography (SPECT) and positron emission tomography (PET) imaging.


RESULTS
SPECT and PET imaging had 100% correlation. Anatomical imaging was abnormal in only 6 of the 8 patients. Wernicke's area showed greater peak Z score reduction and extent of area affected than Broca's area (McNemar paired test: P = .008 for Z score reduction; P = .0003 for extent). PET scanning revealed significant involvement of the anterior cingulum.


CONCLUSIONS
Functional imaging in PPA: (a) identified more patients correctly than anatomic imaging highlighting the importance of SPECT and PET in the diagnosis; and (b) demonstrated the heterogeneous involvement of disordered linguistic networks in PPA suggesting its syndromic nature.
Panegyres
P K
PK
Neurosciences Unit, Health Department of Western Australia, Mt Claremont, Western Australia, Australia. macfarlane4@optusnet.co.au
McCarthy
M
M
Campbell
A
A
Lenzo
N
N
Fallon
M
M
Thompson
J
J
D000368:Aged; D001039:Aphasia, Broca / Q000175:diagnosis / Q000503:physiopathology; D018888:Aphasia, Primary Progressive / Q000175:diagnosis* / Q000503:physiopathology*; D001041:Aphasia, Wernicke / Q000175:diagnosis / Q000503:physiopathology; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D001927:Brain Diseases / Q000175:diagnosis / Q000503:physiopathology; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D005462:Fluorine Radioisotopes; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D012720:Severity of Illness Index; D013223:Statistics as Topic; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
D005462:Fluorine Radioisotopes; D019690:Technetium Tc 99m Exametazime