Alzheimer's disease and frontotemporal dementia are differentiated by discriminant analysis applied to 99mTc HmPAO SPECT data

Charpentier, P.; Lavenu, Isabelle; Defebvre, Luc; Duhamel, Alain; Lecouffe, P.; Pasquier, Florence; Steinling, M.

doi:10.1136/jnnp.69.5.661

Cited by 94 publications

(55 citation statements)

References 15 publications

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“…The largest effect was observed for the PPA subgroup in the left anterior temporal lobe (effect size 4.5). Our classifi cation results are consistent with results from discriminant analyses of functional neuroimaging in dementia using SPECT data [42] . Global brain atrophy of FTD subjects was more severe than in AD subjects compared to NC.…”

Section: Discussionsupporting

confidence: 80%

Topographical Patterns of Lobar Atrophy in Frontotemporal Dementia and Alzheimer’s Disease

Bocti

Rockel²,

Roy³

et al. 2006

Dement Geriatr Cogn Disord

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Background/Aims: Fronto-temporal dementia (FTD) designates a group of relatively common neurodegenerative disorders. The aim of this study was to characterize the patterns of brain atrophy in FTD compared to Alzheimer’s disease (AD). Methods: A novel semiautomatic volumetric MRI analysis method was applied to measure regional brain volumes in FTD (n = 15; behavioural variant n = 9, language variant n = 6) in contrast with AD patients (n = 15) and age-matched controls (NC) (n = 15). FTD and AD patients were matched on demographic measures and Mini Mental State Examination scores. Results: Significant atrophy was present in the frontal and anterior temporal lobes of subjects with FTD compared to AD (p = 0.02; effect size = 1.11) and compared to NC (p < 0.001; effect size = 1.86). Severe atrophy of the left anterior temporal region distinguished the language variant. AD patients, by contrast, did not differ from NC for frontal lobe volume but had smaller anterior temporal lobes (p = 0.03). Both dementia groups had medial temporal lobe atrophy of similar magnitude. A logistic regression model including 4 regional measures correctly classified 100% of subjects. Conclusion: FTD can be reliably differentiated from AD by virtue of a topographical pattern of atrophy involving the frontal lobes and anterior temporal regions. Medial temporal lobe volumes do not distinguish FTD from AD.

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Section: Discussionsupporting

confidence: 80%

Topographical Patterns of Lobar Atrophy in Frontotemporal Dementia and Alzheimer’s Disease

Bocti

Rockel²,

Roy³

et al. 2006

Dement Geriatr Cogn Disord

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“…It might be speculated that the drug effect is more likely to be found in those areas less involved by the disease process at least in mild and moderate stages of the disease, such as the frontal ones [40,41]. Such an interpretation would also be in keeping with the relative perfusion increase mainly found in frontal areas reported by single photon emission computed tomography in AD patients receiving Dz for several weeks [42].…”

Section: Discussionsupporting

confidence: 55%

Quantitative EEG Changes in Alzheimer Patients during Long-Term Donepezil Therapy

Rodriguez¹,

Vitali²,

Leo³

et al. 2002

Neuropsychobiology

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Twenty patients affected with probable mild-to-moderate Alzheimer’s disease (AD; NINCDS-ADRDA criteria; 14 women and 6 men, mean age 75.2 ± 7.1 years) who regularly received an oral acetylcholinesterase inhibitor (AChEI; donepezil 5 mg/day; Dz group) were compared with a control group of 11 AD patients (6 women and 5 men, mean age 73.5 ± 6.0 years) diagnosed and followed up in the pre-AChEIs era (C group). At basal evaluation (t₀), the 2 groups were comparable for age, education, and severity of disease (Global Deterioration Scale). All patients underwent quantitative EEG (qEEG, average reference, 10–20 International System), and were reexamined about 1 year later (t₁; i.e., after 12.3 ± 3.6 months the Dz group, and after 13.7 ± 3.9 months the C group). Log-transformed values of two qEEG bands, i.e. 2–6 and 6.5–12 Hz, were averaged between adjacent channels (frontal F3 and F7, F4 and F8; parietotemporal P3 and T7, P4 and T8) to obtain a qEEG ratio (6.5–12/2–6 Hz.) from one frontal and one temporoparietal region in each hemisphere. Neuropsychological impairment was summarized by the Mini-Mental Status Examination (MMSE). At t₀, both the MMSE score and the qEEG ratio values were somewhat higher in the C than in the Dz group, although nonsignificantly. Between t₀ and t₁, the MMSE score decreased significantly (p < 0.01) more in the C group (–4.36 ± 2.25) than in the Dz group (–1.45 ± 2.16), as did the qEEG ratio in the right frontal region (p < 0.01), whereas in the left frontal region the significance level was not reached (p = 0.02). Between t₀ and t₁, the qEEG ratio difference in both frontal regions and in the right temporoparietal region significantly correlated with the MMSE difference (p < 0.01), but neither with time between examinations nor with the difference on the Visual Search Test score. Long-term treatment with Dz led to a lesser deterioration of qEEG, paralleling a milder neuropsychological decline. The effect was significant in frontal regions, possibly because they are relatively spared during the mild-to-moderate phases of the disease.

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“…Diagnosis of bvFTD remains difficult, with patients being erroneously diagnosed with Alzheimer's disease (AD) or psychiatric disorders 5, 6, 7. A large body of work has demonstrated that brain imaging, in particular structural magnetic resonance imaging (MRI) and functional imaging of cerebral blood flow (CBF) with SPECT or cerebral metabolic rate of glucose (CMRgl) with fluorodeoxyglucose (FDG) positron emission tomography (PET), can improve the accuracy of differential diagnosis in bvFTD 8, 9, 10, 11, 12, 13, 14, 15, 16, 17. These findings led the Center for Medicare and Medicaid Services (CMS) to approve FDG‐PET as a diagnostic test for differentiating bvFTD from AD (https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=288&ncdver=3&bc=BAABAAAAAAAA&).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic utility of ASL‐MRI and FDG‐PET in the behavioral variant of FTD and AD

Tosun

Schuff

Rabinovici

et al. 2016

Ann Clin Transl Neurol

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ObjectiveTo compare the values of arterial spin‐labeled (ASL) MRI and fluorodeoxyglucose (FDG) PET in the diagnosis of behavioral variant of frontotemporal dementia (bvFTD) and Alzheimer's disease (AD).MethodsPartial least squares logistic regression was used to identify voxels with diagnostic value in cerebral blood flow (CBF) and cerebral metabolic rate of glucose (CMRgl) maps from patients with bvFTD (n = 32) and AD (n = 28), who were compared with each other and with cognitively normal controls (CN, n = 15). Diagnostic values of these maps were compared with each other.ResultsRegions that differentiated each disorder from controls were similar for CBF and CMRgl. For differentiating AD from CN, the areas under the curve (AUC) for CBF (0.89) and CMRgl (0.91) were similar, with similar sensitivity (CBF: 86%, CMRgl: 78%) and specificity (CBF: 92%, CMRgl: 100%). Likewise, for differentiating bvFTD from CN performances of CBF (AUC = 0.83) and CMRgl (AUC = 0.85) were equivalent, with similar sensitivity (CBF: 78%, CMRgl: 79%) and specificity (CBF: 92%, CMRgl: 100%). In differentiating bvFTD from AD, classification was again similar for CBF (AUC = 0.87) and CMRgl (AUC = 0.79), as were sensitivity (CBF: 83%, CMRgl: 89%) and specificity (CBF: 93%, CMRgl: 78%). None of the differences in any performance measure were statistically significant.InterpretationASL‐MRI has similar diagnostic utility as FDG‐PET in the diagnosis of AD and bvFTD. Continued development of ASL‐MRI as a diagnostic tool for neurodegenerative dementias is warranted.

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Alzheimer's disease and frontotemporal dementia are differentiated by discriminant analysis applied to 99mTc HmPAO SPECT data

Cited by 94 publications

References 15 publications

Topographical Patterns of Lobar Atrophy in Frontotemporal Dementia and Alzheimer’s Disease

Topographical Patterns of Lobar Atrophy in Frontotemporal Dementia and Alzheimer’s Disease

Quantitative EEG Changes in Alzheimer Patients during Long-Term Donepezil Therapy

Diagnostic utility of ASL‐MRI and FDG‐PET in the behavioral variant of FTD and AD

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