title: Is long-term prognosis of frontotemporal lobar degeneration predictable by neuroimaging? Evidence from a single-subject functional brain study.
abstract: Prediction of survival in frontotemporal lobar degeneration (FTLD) is guesswork. The aim of the present study was to evaluate whether SPECT scan may be useful to predict prognosis of long term survival in FTLD patients. A cohort of 125 patients with FTLD who underwent brain SPECT scan at the time of enrollment and who were further followed up for at least one year were considered. In each subject, volume of interests (VOIs) covering frontotemporal and parietal regions, bilaterally, were drawn. Principal component analysis (PCA) was applied on VOIs, and a Cox regression model was carried out to find out best predictors of survival. A two-pattern PCA solution was chosen, explaining more than 70% of variance, and "frontal" PC1 and "temporal" PC2 components were identified. The frontal PC1 was associated with higher rate of faster progression (HR = 2.06, 95% CI = 1.23-3.44, p = 0.006 for univariate model, and HR = 1.85, 95% CI = 1.04-3.28, p = 0.03 for multivariate model). In particular, right orbitofrontal cortex showed the higher loadings in PC1; the worse the scores of this region the shorter the survival was reported. We suggest that SPECT imaging, beyond a helpful tool in diagnostic assessment, may be an easily and accessible marker of disease outcome in FTLD. Further studies considering structural neuroimaging are warranted.
authors.affiliation: Center for Aging Brain and Dementia, Department of Neurology, University of Brescia, Brescia, Italy. bborroni@inwind.it
authors.forename: Barbara
authors.initials: B
authors.lastname: Borroni
authors.forename: Mario
authors.initials: M
authors.lastname: Grassi
authors.forename: Enrico
authors.initials: E
authors.lastname: Premi
authors.forename: Antonella
authors.initials: A
authors.lastname: Alberici
authors.forename: Maura
authors.initials: M
authors.lastname: Cosseddu
authors.forename: Vanessa
authors.initials: V
authors.lastname: Cancelli
authors.forename: Federico
authors.initials: F
authors.lastname: Caobelli
authors.forename: Barbara
authors.initials: B
authors.lastname: Paghera
authors.forename: Alessandro
authors.initials: A
authors.lastname: Padovani
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology*; D003545:Cysteine / Q000031:analogs & derivatives; D018450:Disease Progression; D005260:Female; D057174:Frontotemporal Lobar Degeneration / Q000000981:diagnostic imaging* / Q000401:mortality; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D025341:Principal Component Analysis; D016019:Survival Analysis; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015609:Organotechnetium Compounds; C059659:technetium Tc 99m bicisate; D003545:Cysteine