title: Distinct patterns of medial temporal impairment in degenerative dementia: a brain SPECT perfusion study in Alzheimer's disease and frontotemporal dementia.
abstract: OBJECTIVE
  Medial temporal impairment can be detected clinically and by morphological imaging during Alzheimer's disease (AD), but the existence of a functional impairment in this area seems to be less well established. Yet such functional impairment is classically found in other degenerative cortical dementias, such as the frontal variant of frontotemporal dementia (fv-FTD). The aim of this study was to characterize and compare brain SPECT perfusion of the medial temporal lobe in AD and fv-FTD.
  
  
  METHODS
  Voxel-based comparisons were performed using SPM8 between cerebral SPECT images from 85 AD patients, 25 fv-FTD patients and 12 healthy controls at the whole-brain level and the medial temporal lobe level using a region of interest approach (p < 0.001, corrected for the cluster).
  
  
  RESULTS
  In the free and cued selective reminding test, used to evaluate medial temporal memory function, AD patients had significantly lower scores than the fv-FTD patients (p < 0.005). AD and fv-FTD patients showed hypoperfused medial temporal structures in comparison to normal controls. However, fv-FTD patients had more pronounced hypoperfusion in this area, with a different topography, more anterior and more parahippocampal.
  
  
  CONCLUSIONS
  These results show that medial temporal hypoperfusion can be detected in degenerative dementias by SPECT. Paradoxically, the hypoperfusion is more severe in fv-FTD than in AD patients, even though the mnesic profile of AD is more altered, suggesting the existence of inefficient compensatory mechanisms.
authors.affiliation: Service de Médecine Nucléaire, Hôpital d'Instruction des Armées Sainte Anne, Toulon, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Basely
authors.forename: Mathieu
authors.initials: M
authors.lastname: Ceccaldi
authors.forename: Laurent
authors.initials: L
authors.lastname: Boyer
authors.forename: Olivier
authors.initials: O
authors.lastname: Mundler
authors.forename: Eric
authors.initials: E
authors.lastname: Guedj
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000000981:diagnostic imaging*; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D003704:Dementia / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D057180:Frontotemporal Dementia / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D012372:ROC Curve; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon
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