title: Differentiation of frontotemporal dementia from dementia with Lewy bodies using FP-CIT SPECT.
abstract: BACKGROUND
  There is increasing evidence that imaging with [123I]FP-CIT SPECT is helpful in differentiating dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) but it is not known how well the scan performs in differentiating DLB from frontotemporal dementia (FTD).
  
  
  METHODS
  We compared the striatal dopamine transporter (DAT) binding in FTD (n=12), DLB (n=10) and AD (n=9) by visually rating the caudate and putamen on [123I]FP-CIT SPECT scans.
  
  
  RESULTS
  The majority (9/10) of DLB cases had an abnormal scan and a significant reduction of uptake of DAT binding in the putamen and the caudate. A third (4/12) of the FTD cases also had an abnormal scan and a significant reduction in uptake in the putamen and the caudate. In contrast, only one out of nine AD cases had an abnormal scan. Significant differences were found when comparisons were made between the groups for visual analysis of the entire scan (p=0.001) and the four regions of interest (p=0.001 - 0.013). In contrast to the AD group (specificity of scan 89%), the specificity of [123I]FP-CIT SPECT scans was reduced in the FTD group to 67%. Three quarters of the study population had at least one extrapyramidal motor sign (EPMS), with bradykinesia being the most common EPMS in both FTD (83%) and DLB (70%).
  
  
  CONCLUSIONS
  This study highlights to clinicians that a positive (abnormal) [123I]FP-CIT SPECT scan, even in a patient with an EPMS, does not exclude the diagnosis of FTD and emphasises the importance of a comprehensive clinical evaluation and a detailed cognitive assessment.
authors.affiliation: Older People and Healthy Aging Directorate, Central and North West London NHS Foundation Trust, Bently House, 15-21 Headstone Drive, Middlesex, London, HA3 5QX, UK. s.morgan1@nhs.net
authors.forename: Shirlony
authors.initials: S
authors.lastname: Morgan
authors.forename: Paul
authors.initials: P
authors.lastname: Kemp
authors.forename: Jan
authors.initials: J
authors.lastname: Booij
authors.forename: Durval C
authors.initials: DC
authors.lastname: Costa
authors.forename: Shalandran
authors.initials: S
authors.lastname: Padayachee
authors.forename: Lean
authors.initials: L
authors.lastname: Lee
authors.forename: Christopher
authors.initials: C
authors.lastname: Barber
authors.forename: Janet
authors.initials: J
authors.lastname: Carter
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Walker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D002421:Caudate Nucleus / Q000000981:diagnostic imaging / Q000378:metabolism; D003937:Diagnosis, Differential; D050483:Dopamine Plasma Membrane Transport Proteins / Q000378:metabolism; D005260:Female; D057180:Frontotemporal Dementia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D007457:Iodine Radioisotopes; D020961:Lewy Body Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D008297:Male; D011699:Putamen / Q000000981:diagnostic imaging / Q000378:metabolism; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014326:Tropanes
chemical_list: D050483:Dopamine Plasma Membrane Transport Proteins; D007457:Iodine Radioisotopes; D014326:Tropanes; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane