Frontotemporal decreases in rCBF correlate with degree of dysnomia in primary progressive aphasia.

Abstract

UNLABELLED:

Primary progressive aphasia (PPA) is an uncommon degenerative dementia characterized by gradual impairment of language function with initial sparing of the memory domain. Using semiquantitative 99mTc-hexamethyl propyleneamine oxime (HMPAO) brain SPECT as a measure of regional cerebral blood flow (rCBF), we investigated the relationship between reduced 99mTc-HMPAO uptake and the severity of dysnomia in PPA.

METHODS:

Seven right-handed patients with PPA had their dysnomia assessed by the Boston Naming Test (BNT), a subtest of the Boston Diagnostic Aphasia Examination. Neuroimaging studies, including 99mTc-HMPAO brain SPECT, CT, and MRI, were performed. Correlational analysis between reduced rCBF and BNT was performed.

RESULTS:

Brain SPECT showed a reduction in 99mTc-HMPAO uptake involving the frontal and temporal lobes in all 7 patients. CT and MRI showed mild to moderate cerebral atrophy in 4 patients. Low scores on the BNT correlated with low frontotemporal 99mTc-HMPAO (Spearman r = 0.97, P = 0.004) in the 5 patients with left-hemisphere involvement.

CONCLUSION:

Decreased rCBF to the frontotemporal region characterized the cerebral abnormalities associated with PPA. The finding of focal rCBF abnormalities in the right hemisphere of 2 right-handed women corroborates that PPA symptoms may arise from a "non-left-dominant"-hemisphere degenerative process. Our results support the usefulness of rCBF SPECT imaging as a diagnostic aid in PPA.

• Authors: E C San Pedro, G Deutsch, H G Liu, J M Mountz
• Journal: Journal of nuclear medicine : official publication, Society of Nuclear Medicine (J Nucl Med) Vol. 41 Issue 2 Pg. 228-33 (Feb 2000) ISSN: 0161-5505 [Print] United States
• PMID: 10688104 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Radiopharmaceuticals
• Technetium Tc 99m Exametazime

Topics

• Aged
• Anomia (diagnostic imaging, physiopathology)
• Aphasia, Primary Progressive (diagnosis, diagnostic imaging, physiopathology)
• Cerebrovascular Circulation (physiology)
• Female
• Frontal Lobe (diagnostic imaging)
• Humans
• Male
• Neuropsychological Tests
• Radiopharmaceuticals
• Technetium Tc 99m Exametazime
• Temporal Lobe (diagnostic imaging)
• Tomography, Emission-Computed, Single-Photon