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Controlled Clinical Trial
. 2006 Oct 10;67(7):1215-20.
doi: 10.1212/01.wnl.0000238163.71349.78.

Hypoperfusion in frontotemporal dementia and Alzheimer disease by arterial spin labeling MRI

A T Du  1 , G H Jahng, S Hayasaka, J H Kramer, H J Rosen, M L Gorno-Tempini, K P Rankin, B L Miller, M W Weiner, N Schuff
Affiliations
Controlled Clinical Trial

Hypoperfusion in frontotemporal dementia and Alzheimer disease by arterial spin labeling MRI

A T Du et al. Neurology. .

Abstract

Objectives: To test if arterial spin labeling (ASL) MRI could detect a pattern of hypoperfusion in frontotemporal dementia (FTD) vs cognitively normal (CN) control subjects; to determine the regional difference of perfusion between FTD and Alzheimer disease (AD); and to determine whether hypoperfusion in FTD correlates with cognitive impairment.

Methods: We included 21 patients with FTD, 24 patients with AD, and 25 CN subjects in this cross-sectional MRI study. All subjects had MRI scans including T1-weighted structural images and ASL-MR images.

Results: ASL-MRI detected a pattern of hypoperfusion in right frontal regions in patients with FTD vs CN subjects, similar to PET and SPECT. FTD had higher perfusion than AD in the parietal regions and posterior cingulate. Frontal hypoperfusion in FTD correlated with deficits in judgment and problem solving. Adding frontal perfusion to gray matter (GM) atrophy significantly improved the classification of FTD from normal aging to 74%, and adding parietal perfusion to GM atrophy significantly improved the classification of FTD from AD to 75%. Combining frontal and parietal lobe perfusion further improved the classification of FTD from AD to 87%.

Conclusion: Frontotemporal dementia and Alzheimer disease display different spatial distributions of hypoperfusion on arterial spin labeling MRI. With further development and evaluation, arterial spin labeling MRI could contribute to the differential diagnosis between frontotemporal dementia and Alzheimer disease.

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Figures

Figure 1
Figure 1
Representative structural and arterial spin labeling MR perfusion images after partial volume corrections from a cognitive normal (CN) individual, a patient with frontotemporal dementia (FTD), and a patient with Alzheimer disease (AD). Notes diminished perfusion in frontal brain regions (arrow) in the patient with FTD and posterior brain regions (arrows) in the patient with AD vs the CN subject.
Figure 2
Figure 2
Regional hypoperfusion in patients with frontotemporal dementia vs healthy control subjects before (A) and after (B) correction for partial volume effects. The intensities of color coding in these renderings (including figures 2 and 3) are a weighted sum of t values, where the weights are proportional to the depth within the brain; that is, deeper regions will be shown with less intensities.
Figure 3
Figure 3
Regional hyperperfusion in frontotemporal dementia (FTD) vs Alzheimer disease (AD) before (A) and after (B) correction for partial volume effects. (C) Regional hyperperfusion in FTD compared with AD after accounting for variations in dementia severity as measured using Mini-Mental State Examination scores and Clinical Dementia Rating box scores.
See this image and copyright information in PMC

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