Correlative Studies of Structural and Functional Imaging in Primary Progressive Aphasia

Rationale: To compare and contrast structural and functional imaging in primary progressive aphasia (PPA). Methods: A cohort of 8 patients diagnosed with PPA presenting with nonfluency were prospectively evaluated. All patients had structural imaging in the form of MRI and in 1 patient CAT scanning...

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Published in:American journal of Alzheimer's disease and other dementias 2008-04, Vol.23 (2), p.184-191
Main Authors: Panegyres, P.K., McCarthy, M., Campbell, A., Lenzo, N., Fallon, M., Thompson, J.
Format: Article
Language:English
Subjects:
Aged
Aphasia, Broca - diagnosis
Aphasia, Broca - physiopathology
Aphasia, Primary Progressive - diagnosis
Aphasia, Primary Progressive - physiopathology
Aphasia, Wernicke - diagnosis
Aphasia, Wernicke - physiopathology
Brain - pathology
Brain - physiopathology
Brain Diseases - diagnosis
Brain Diseases - physiopathology
Diagnostic Imaging - methods
Female
Fluorine Radioisotopes
Functional Laterality
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Positron-Emission Tomography
Prospective Studies
Severity of Illness Index
Statistics as Topic
Technetium Tc 99m Exametazime
Tomography, Emission-Computed, Single-Photon
Tomography, X-Ray Computed
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Summary:Rationale: To compare and contrast structural and functional imaging in primary progressive aphasia (PPA). Methods: A cohort of 8 patients diagnosed with PPA presenting with nonfluency were prospectively evaluated. All patients had structural imaging in the form of MRI and in 1 patient CAT scanning on account of a cardiac pacemaker. All patients had single-photon emission computed tomography (SPECT) and positron emission tomography (PET) imaging. Results: SPECT and PET imaging had 100% correlation. Anatomical imaging was abnormal in only 6 of the 8 patients. Wernicke's area showed greater peak Z score reduction and extent of area affected than Broca's area (McNemar paired test: P = .008 for Z score reduction; P = .0003 for extent). PET scanning revealed significant involvement of the anterior cingulum. Conclusion: Functional imaging in PPA: (a) identified more patients correctly than anatomic imaging highlighting the importance of SPECT and PET in the diagnosis; and (b) demonstrated the heterogeneous involvement of disordered linguistic networks in PPA suggesting its syndromic nature.
ISSN:1533-3175
1938-2731
DOI:10.1177/1533317507312621