Implication of Ventricular Asymmetry Analyzed by Neuropsychological Test and Tc-99m ECD SPECT
in Patients with Frontotemporal Dementia

J Korean Neurol Assoc > Volume 26(1); 2008 > Article

Journal of the Korean Neurological Association 2008;26(1): 1-7.

전두측두치매 환자에서의 신경심리 검사 및 Tc-99m ECD SPECT를 통해 분석한 뇌실 비대칭성의 의의

김태학, 김병채 최성민 김준태 이승한 박만석 송호천a 김명규 조기현

전남대학교 의과대학 신경과학교실, 핵의학교실

Implication of Ventricular Asymmetry Analyzed by Neuropsychological Test and Tc-99m ECD SPECT in Patients with Frontotemporal Dementia

Tae-Hak Kim

Department of Neurology and Nuclear Medicinea, Chonnam National University Medical School, Gwangju, Korea

Abstract

Background: Frontotemporal dementia (FTD) has a characteristic pattern of lobar atrophy in frontal and/or temporal lobes. Asymmetry in the lateral ventricle size on brain magnetic resonance image (MRI) in FTD patients may have clinical significance. This study compares the ventricular asymmetry seen on MRI with that of the neuropsychological difference and asymmetric hypoperfusion using statistical parametric mapping (SPM) analysis of brain SPECT in patients with FTD.
Methods: Thirteen FTD patients who underwent Brain MRI, TC-99m ECD SPECT and neuropsychological testing and who had the ventricular asymmetry on brain MRI were retrospectively selected. The patients were divided into two groups (5 right dominant group, 8 left dominant group) according to the ventricular asymmetry on brain MRI. We compared the regional blood flow pattern on TC-99m ECD SPECT images using SPM analysis and the results of neuropsychological tests between the two groups.
Results: In the right dominant group, a significant perfusion deficit was identified at the bilateral frontal regions. In the left dominant group, significant hypoperfusion was found at the left frontotemporal regions (uncorrected p<0.001). There was no significant difference of neuropsychological testing in between the two groups. However, the score on the Neuropsychiatric Inventory (NPI) in the right dominant group was higher than that of the left dominant group (p=0.043).
Conclusions: Hemispheric asymmetry on brain MRI was common in patients with FTD and was related with a characteristic pattern of hypoperfusion on brain SPECT images and neuropsychiatric symptoms. KeyWords:Frontotemporal dementia, Statistical parametric mapping, Ventricular asymmetry