전두측두치매 환자에서의 신경심리 검사 및 Tc-99m ECD SPECT를 통해 분석한 뇌실 비대칭성의 의의
Implication of Ventricular Asymmetry Analyzed by Neuropsychological Test and Tc-99m ECD SPECTin Patients with Frontotemporal Dementia
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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.
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.
참고문헌 (25)
- Pasquier F, "Non-Alzheimer degenerative dementias", Curr Opin Neurol, 11, pp.417~427 (1998)
- Neary D, "Dementia of frontal lobe type", J Neurol Neurosurg Psychiatry, 51, pp.353~361 (1988)
- Fazekas F, "Comparison of CT, MR, and PET in Alzheimer’s dementia and normal aging", J Nucl Med, 30, pp.1607~1615 (1989)
- Boccardi M, "The MRI pattern of frontal and temporal brain atrophy in fronto-temporal demantia", Neurobiol Aging, 24, pp.95~103 (2003)
- Short RA, "Different patterns of magnetic resonance imaging atrophy for frontotemporal lobar degeneration syndromes", Arch Nerol, 62, pp.1106~1110 (2005)
- Boone KB, "Neuropsychological patterns in right versus left frontotemporal dementia", J Int Neuropsychol Soc, 5, pp.616~622 (1999)
- Miller BL, "Progressive right frontotemporal degeneration: clinical, neuropsychological and SPECT characteristics", Dementia, 4, pp.204~213 (1993)
- Jeong Y, "18F- FDG PET findings in frontotemporal dementia: an SPM analysis of 29 patients", J Nucl Med, 46, pp.233~239 (2005)
- Jeong Y, "Correlation of ventricular asymmetry with metabolic asymmetry in frontotemporal dementia", J Neuroradiol, 32, pp.247~254 (2005)
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders. 4th ed (DSM-IV)", American Psychiatric Association, pp.143~147 (1994)
- Neary D, "Frontotemporal lobar degeneration: a consensus on clinical disgnostic criteria", Neurology, 51, pp.1546~1554 (1998)
- Christensen KJ, "A cognitive battery for dementia: development and measurement characteristic", Psychol Assess, 3, pp.168~174 (1991)
- Victoroff J, "A method to improve interrater reliability of visual inspection of brain MRI scans in dementia", Neurology, 44, pp.2267~2276 (1994)
- Rosen HJ, "Patterns of brain atrophy in frontotemporal dementia and semantic dementia", Neurology, 58, pp.198~208 (2002)
- Kang YW, "A validity study on the Korean mini-mental state examination (K-MMSE) in dementia patients", J Korean Neurol Assoc, 15, pp.300~307 (1997)
- Whitwell JL, "Magnetic resonance imaging signatures of tissue pathology in frontotemporal dementia", Arch Neurol, 62, pp.1402~1408 (2005)
- Hooten WM, "Frontotemporal dementia: a clinicopathological review of four postmortem studies", J Neuropsychiatry Clin Neurosci, 8, pp.10~19 (1996)
- Warkentin S, "Functional imaging of the frontal lobes in organic dementia. Regional cerebral blood flow findings in normals, in patients with frontotemporal dementia and in patients with Alzheimer’s disease, performing a word fluency test", Dement Geriatr Cogn Disord, 8, pp.105~109 (1997)
- Nawab Q, "Evidence-based dementia practice. 1st ed", Oxford, pp.305~306 (2002)
- Miller BL, "Neuroimaging in the diagnosis of frontotemporal dementia", Dement Geriatr Cogn Disord, 1, pp.71~74 (1999)
- Elfgren CI, "Performance on neuropsychological tests related to single photon emission computerised tomography findings in frontotemporal dementia", Br J Psychiatry, 169, pp.416~422 (1996)
- Yang DW, "Analysis of cerebral blood flow of subcortical vascular dementia with single photon emission computed tomography: Adaptation of statistical parametric mapping", J Neurol Sci, 15, pp.199~205 (2002)
- Friston KJ, "Statistical parametric maps in functional imaging: general approach", Hum Brain Mapp, 2, pp.189~210 (1995)
- u YH, "The role of functional imaging techniques in the dementia", Korean J Nucl Med, 38, pp.209~217 (2004)
- Anderson B, "Anatomic asymmetries of the posterior superior temporal lobes: a postmortem study", Neuropsychiatry Neuropsychol Behav Neurol, 12, pp.247~254 (1999)