J Korean Neurol Assoc > Volume 21(1); 2003 > Article

Journal of the Korean Neurological Association 2003;21(1): 32-40.

"전두엽형 알쯔하이머병의 신경심리 및 신경영상학적 소견"

정용 , 한도훈 이현아 조상수 진주희 강수진 김상은 나덕렬

"성균관대학교 의과대학 삼성서울병원 신경과학교실,핵의학교실,성균관대학교 인지과학과 ,계명대학교 동산의료원 신경과학교실"

"Neuropsychological and Neuroimaging Findings of Frontal Variant of Alzheimer　s Disease"

Yong Jeong

"Departments of Neurology and Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Cognitive Science, Sungkyunkwan University,Department of Neurology, Keimyung University School of Medicine"

Abstract

"Background : Patients with Alzheimer　s disease (AD) at an early stage present with memory decline and impair-ments of language and visuospatial functions. However, some AD patients occasionally show frontal lobe dysfunctions in the early stage those are known to emerge only at the advanced stage. This subtype of AD is called a frontal variant of AD (frontal AD). We report neuropsychological and FDG-PET findings of three cases of frontal AD. Methods : Three patients met the diagnostic criteria of probable AD proposed by the NINCDS-ADRDA. However, they unusually showed clinical symptoms associated with frontal lobe dysfunctions even if they were relatively in the early stage of dementia. All the patients underwent neuropsychological tests and brain FDG-PET scans. Distribution of glucose hypometabolism was analyzed using statistical parametric mappings (SPM). Results : Results of neuropsychological tests were consistent with findings of AD except that frontal lobe dysfunctions were prominent. FDG-PET scans and SPM analysis of these images showed hypometabolism in the frontal as well as temporo-parietal regions. Unlike the hypometabolism pattern found in frontotemporal dementia, frontal hypometabolism in our patients was not as severe as parietal hypometablism and hypometabolic regions within the temporal lobe were in the middle or posterior part of the middle and inferior temporal gyri rather than in the anterior part. Conclusions : Detailed neuropsycholgical tests and FDG-PET may help differentiate AD with frontal involvement in its early stage (frontal AD) from frontotemporal dementia. Future studies with FDG-PET in a larger series of frontal AD cases, especially with histologically proven cases, may be needed.Key Words : Alzheimer　s disease, Frontal lobe, Neuropsychological test, FDG-PET, SPM, Frontotemporal dementia"