title: Brain perfusion patterns in familial frontotemporal lobar degeneration.
abstract: OBJECTIVE
  Frontotemporal lobar degeneration (FTLD) is a clinically, genetically, and pathologically heterogeneous disorder. The aim of this study was to compare clinical features and perfusion patterns on SPECT of patients with familial FTLD-TAR DNA binding protein 43 kDa (TDP) and MAPT mutations.
  
  
  METHODS
  Patients were included if they had MAPT or GRN mutations, positive family history with pathologically proven FTLD in the patient or first-degree relative, or were part of FTD-MND families. All patients and 10 age- and gender-matched controls underwent measurement of brain perfusion using (99m)Tc-HMPAO SPECT. We used SPM8 to perform image processing and voxel-based group analyses (p < 0.001). Gender and age were included as nuisance variables in the design matrices.
  
  
  RESULTS
  Of the 29 patients with familial FTLD, 19 had familial FTLD-TDP (GRN mutations in 6), and 10 had MAPT mutations. At clinical presentation, familial FTLD-TDP patients were older at onset (p = 0.030) and had more memory deficits (p = 0.011), whereas patients with MAPT had more naming deficits (p < 0.001) and obsessive-compulsive behavior (p = 0.001). The between-groups SPECT analyses revealed significantly less perfusion in the right frontal lobe, precuneus, cuneus, and inferior parietal lobule in familial FTLD-TDP, whereas significantly less perfusion was found in the left temporal and inferior frontal gyri in MAPT. Post hoc analysis of familial FTLD-TDP with unknown genetic defect vs MAPT revealed less perfusion in the right frontal and parietal lobe.
  
  
  CONCLUSIONS
  Familial FTLD-TDP shows relatively more posterior hypoperfusion, including the precuneus and inferior parietal lobule, possibly related to significant memory impairment. Patients with MAPT were characterized by impaired perfusion of the temporal regions and naming deficits.
authors.affiliation: Department of Neurology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Seelaar
authors.forename: J M
authors.initials: JM
authors.lastname: Papma
authors.forename: G
authors.initials: G
authors.lastname: Garraux
authors.forename: I
authors.initials: I
authors.lastname: de Koning
authors.forename: A E
authors.initials: AE
authors.lastname: Reijs
authors.forename: R
authors.initials: R
authors.lastname: Valkema
authors.forename: A J M
authors.initials: AJ
authors.lastname: Rozemuller
authors.forename: E
authors.initials: E
authors.lastname: Salmon
authors.forename: J C
authors.initials: JC
authors.lastname: van Swieten
mesh_terms: D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging; D004268:DNA-Binding Proteins / Q000235:genetics / Q000502:physiology; D005260:Female; D057174:Frontotemporal Lobar Degeneration / Q000150:complications / Q000235:genetics* / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000235:genetics / Q000502:physiology*; D008297:Male; D008569:Memory Disorders / Q000150:complications / Q000000981:diagnostic imaging / Q000235:genetics / Q000503:physiopathology; D008875:Middle Aged; D009154:Mutation; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000000981:diagnostic imaging / Q000235:genetics / Q000503:physiopathology; D000077153:Progranulins; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D016875:tau Proteins / Q000235:genetics / Q000502:physiology*
chemical_list: D004268:DNA-Binding Proteins; C492314:GRN protein, human; D036341:Intercellular Signaling Peptides and Proteins; C054369:MAPT protein, human; D000077153:Progranulins; D016875:tau Proteins; D019690:Technetium Tc 99m Exametazime