Zusammenfassung
Mittels Positronenemissionstomographie (PET) sollten zerebrale Regionen identifiziert
werden, in denen sich Demenzen aus der Gruppe der frontotemporalen lobären Degenerationen
(FTLD) in ihrem Glukosestoffwechsel von der Alzheimer-Krankheit (AD) unterscheiden.
Es wurden je 14 Patienten mit der klinischen Diagnose FTLD bzw. AD untersucht. Signifikante
Unterschiede zeigten sich in der linken Insula, im Gyrus frontalis medialis beidseits
und im rechten Gyrus temporalis medialis. Die PET könnte daher ein viel versprechender
Baustein bei der Differenzialdiagnose dieser demenziellen Syndrome sein.
Abstract
Objective: To describe differences in cerebral glucose metabolism between frontotemporal lobar
degeneration (FTLD) and Alzheimer's disease (AD). Methods: 14 patients with FTLD (7 f/7 m, mean age 60.1 years) and 14 patients with AD (7 f/7
m, mean age 59.5 years) were examined. [18F]FDG positron emission tomography (PET)
scans were analysed with statistical nonparametric mapping (SnPM) and statistical
parametric mapping (SPM99). Results: Significant decreases in glucose metabolism in FTLD compared to AD were detected
in the left insula/left inferior frontal gyrus (Brodman area [BA]13, 45 and 47) and
in the medial frontal gyrus bilaterally (BA10). A significant decrease in AD compared
to FTLD was identified in the right middle temporal gyrus (BA39). Conclusion: Cerebral PET could be a promising tool to discriminate FTLD from AD.
Literatur
- 1
Neary D, Snowden J S, Gustafson L, Passant U, Stuss D, Black S, Freedman M, Kertesz A,
Robert P H, Albert M, Boone K, Miller B L, Cummings J, Benson D F.
Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria.
Neurology.
1998;
51
1546-1554
- 2
Ishii K, Sakamoto S, Sasaki M, Kitagaki H, Yamaji S, Hashimoto M, Imamura T, Shimomura T,
Hirono N, Mori E.
Cerebral glucose metabolism in patients with frontotemporal dementia.
J Nucl Med.
1998;
39
1875-1878
- 3
Nestor P J, Graham N L, Fryer T D, Williams G B, Patterson K, Hodges J R.
Progressive non-fluent aphasia is associated with hypometabolism centred on the left
anterior insula.
Brain.
2003;
126
2406-2418
- 4
Ibach B, Poljansky S, Barta W, Koller M, Wittmann M, Hajak G,. Working Group Geriatric
Psychiatry Germany .
Patterns of referring of patients with frontotemporal lobar degeneration to psychiatric
in- and out-patient services. Results from a prospective multicentre study.
Dement Geriatr Cogn Disord.
2004;
17
269-273
Stefan Poljansky
Bezirksklinikum Regensburg
Universitätsstraße 84
93053 Regensburg
Email: stefan.poljansky@medbo.de