Distinct cerebral perfusion patterns in FTLD and AD.
OBJECTIVE
We examined the utility of distinguishing between patients with frontotemporal lobar degeneration (FTLD) and Alzheimer disease (AD) using quantitative cerebral blood flow (CBF) imaging with arterial spin labeled (ASL) perfusion MRI.


METHODS
Forty-two patients with FTLD and 18 patients with AD, defined by autopsy or CSF-derived biomarkers for AD, and 23 matched controls were imaged with a continuous ASL method to quantify CBF maps covering the entire brain.


RESULTS
Patients with FTLD and AD showed distinct patterns of hypoperfusion and hyperperfusion. Compared with controls, patients with FTLD showed significant hypoperfusion in regions of the frontal lobe bilaterally, and hyperperfusion in posterior cingulate and medial parietal/precuneus regions. Compared with controls, patients with AD showed significant hypoperfusion in the medial parietal/precuneus and lateral parietal cortex, and hyperperfusion in regions of the frontal lobe. Direct comparison of patient groups showed significant inferior, medial, and dorsolateral frontal hypoperfusion in FTLD, and significant hypoperfusion in bilateral lateral temporal-parietal and medial parietal/precuneus regions in AD.


CONCLUSIONS
Doubly dissociated areas of hypoperfusion in FTLD and AD are consistent with areas of significant histopathologic burden in these groups. ASL is a potentially useful biomarker for distinguishing patients with these neurodegenerative diseases.
Hu
W T
WT
Department of Neurology-2 Gibson, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104-4283, USA.
Wang
Z
Z
Lee
V M-Y
VM
Trojanowski
J Q
JQ
Detre
J A
JA
Grossman
M
M
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001931:Brain Mapping; D002560:Cerebrovascular Circulation; D005260:Female; D057174:Frontotemporal Lobar Degeneration / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D013113:Spin Labels
D013113:Spin Labels
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