Midcingulate involvement in progressive supranuclear palsy and tau positive frontotemporal dementia.
BACKGROUND
Progressive supranuclear palsy (PSP) patients often exhibit cognitive decline and behavioural changes during the disease course. In a subset, these symptoms may be the presenting manifestation and can be similar to those in frontotemporal dementia (FTD). However, correlation studies between quantitative imaging measures and detailed neuropsychological assessment are scarce. The aim of this study was to investigate the functional role of affected brain regions in cognition in PSP compared with controls and subsequently examine these regions in FTD patients with known tau pathology (FTD tau).


METHODS
21 PSP patients, 27 healthy controls and 11 FTD tau patients were enrolled. All participants underwent neuropsychological testing and technetium-99m-hexamethyl-propylenamine-oxime single photon emission CT. Regression slope analyses were performed in statistical parametric mapping to find significant associations between neuropsychological test results and brain perfusion.


RESULTS
PSP patients showed hypoperfusion in the midcingulate cortex (MCC) of which the posterior part correlated with Stroop III and Weigl. In FTD tau patients, MCC involvement was located more anterior and correlated with Stroop III and Wisconsin Card Sorting Test concepts. The degree of hypoperfusion in the anterior cortex and MCC in the disorders differed in the subgenual anterior cingulate cortex only.


CONCLUSIONS
The posterior part of the MCC is prominently involved in the neurodegenerative process of PSP, and the severity of its hypoperfusion correlated with the extent of executive dysfunction. In FTD tau, this cognitive domain was associated with anterior MCC involvement. The degree of hypoperfusion in these regions did not differ between PSP and FTD tau. These observations provide insight into the role of the cingulate cortex in cognitive dysfunction in these neurodegenerative disorders and warrant further investigations.
Department of Neurology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Wang Zheng
WZ
Chiu
Janne M
JM
Papma
Inge
I
de Koning
Laura
L
Donker Kaat
Harro
H
Seelaar
Ambroos E M
AE
Reijs
Roelf
R
Valkema
Djo
D
Hasan
Agnita J W
AJ
Boon
John Cornelis
JC
van Swieten
D000368:Aged; D003072:Cognition Disorders / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D057180:Frontotemporal Dementia / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology* / Q000523:psychology*; D059907:Functional Neuroimaging / Q000379:methods / Q000523:psychology*; D006179:Gyrus Cinguli / Q000098:blood supply* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D015609:Organotechnetium Compounds; D010091:Oximes; D019275:Radiopharmaceuticals; D013494:Supranuclear Palsy, Progressive / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods / Q000523:psychology; D016875:tau Proteins / Q000378:metabolism
D015609:Organotechnetium Compounds; D010091:Oximes; D019275:Radiopharmaceuticals; D016875:tau Proteins; C044310:technetium Tc 99m propylene amine oxime