In this paper, the cerebral uptake of 18F-fluoro-2-deoxy-D-glucose (FDG) was studied in a relatively small group of patients suffering from either clinically diagnosed Alzheimer’s disease (AD) or frontotemporal dementia during the initial differential diagnostic workup. The image analysis was done visually and semiquantitatively using three different reference regions. Visual analysis confirmed earlier literature findings on the distribution of decreased FDG uptake and demonstrated prevalent asymmetric patterns in both groups. Only semiquantitative analysis using the sensorimotor cortex as a reference region confirmed the visual findings. Moreover, there were no differences in medial temporal lobe activities between both groups, and there was no correlation of medial temporal lobe activity with dementia severity. In the AD group, a correlation of parietal FDG uptake with MMSE scores was found.

1.
Frackowiak RSJ, Pozzilli C, Legg NJ, De Boulay GH, Marshall J, Lenzi GL, Jones T: Regional cerebral oxygen supply and utilization in dementia. Brain 1981;104:753–778.
2.
Blacker D, Albert MS, Bassett SS, Go RCP, Harrel LE, Folstein MF: Reliability and validity of the NINCDS-ADRDA criteria for Alzheimer’s disease. Arch Neurol 1994;51:1198–1204.
3.
Cummings J, Khachaturion Z: Definitions and diagnostic criteria; in Gauthier S (ed): Clinical Diagnosis and Management of Alzheimer’s Disease. London, Dunitz, 1996, pp 3–15.
4.
Fisher NJ, Rourke BP, Bieliauskas LA, Giordani B, Berent S, Foster NL: Unmasking the heterogeneity of Alzheimer’s disease: Case studies of individuals from distinct neuropsychological subgroups. J Clin Exp Neuropsychol 1997;19:713–754.
5.
Santens P, Van Borsel J, Foncke E, Meire V, Merkx H, De Bleecker J, De Reuck J: Progressive dysarthria. Case reports and a review of the literature. Dement Geriatr Cogn Disord 1999;10:231–236.
6.
Labbé C, Froment JC, Kennedy A, Ashburner J, Cinotti L: Positron emission tomography metabolic data corrected for cortical atrophy using magnetic resonance imaging. Alzheimer Dis Assoc Disord 1996;10:141–170.
7.
Santens P, Petit H: Positron emission tomography in dementia. Acta Neurol Belg 1997;97:192–195.
8.
Salmon E, Sadzot B, Maquet P, Degueldre C, Lemaire C, Rigo P, Comar D, Franck G: Differential diagnosis of Alzheimer’s disease with PET. J Nucl Med 1994;35:391–398.
9.
Herholz K, Perani D, Salmon E, Franck G, Fazio F, Heiss WD, Comar D: Comparability of FDG PET studies in probable Alzheimer’s disease. J Nucl Med 1993;34:1460–1466.
10.
Meltzer CC, Zubieta JK, Brandt J, Tune LE, Mayberg HS, Frost JJ: Regional hypometabolism in Alzheimer’s disease as measured by positron emission tomography after correction for effects of partial volume averaging. Neurology 1996;47:454–461.
11.
Burdette JH, Minoshima S, Van der Borght T, Tran DD, Kuhl DE: Alzheimer disease: Improved visual interpretation of PET images by using three-dimensional stereotactic surface projections. Radiology 1996;198:837–843.
12.
Hoffman JM, Hanson MW, Welsh KA, Earl N, Paine S, Delong D, Coleman RE: Interpretation variability of 18FDG-positron emission tomography studies in dementia. Invest Radiol 1996;31:316–322.
13.
Lammertsma AA, Brooks DJ, Frackowiak RSJ, Beaney RP, Herold S, Heather JD, Palmer AJ, Jones T: Measurement of glucose utilization with [18F]2-fluorodeoxy-D-glucose: A comparison of different analytical methods. J Cereb Blood Flow Metab 1987;7:161–172.
14.
Piert M, Koeppe RA, Giordani B, Berent S, Kuhl DE: Diminished glucose transport and phosphorylation in Alzheimer’s disease determined by dynamic FDG-PET. J Nucl Med 1996;37:201–208.
15.
Duara R, Grady C, Haxby J, Sundaram M, Cutler NR, Heston L, Moore A, Schlageter N, Larson S, Rapoport SI: Positron emission tomography in Alzheimer’s disease. Neurology 1986;36:879–887.
16.
Talbot PR, Lloyd JJ, Snowden JS, Neary D, Testa HJ: Choice of reference region in the quantification of single-photon emission tomography in primary degenerative dementia. Eur J Nucl Med 1994;21:503–508.
17.
Claus JJ, Van Harskamp F, Breteler MMB, Krenning EP, Van der Cammen TJM, Hofuran A, Hasan D: Assessment of cerebral perfusion with single-photon emission tomography in normal subjects and in patients with Alzheimer’s disease: Effects of region of interest selection. Eur J Nucl Med 1994;21:1044–1051.
18.
Small GW, Stern CE, Mandelkern MA, Fairbanks LA, Min CA, Guze BH: Reliability of drawing regions of interest for positron emission tomographic data. Psychiatry Res 1992;45:177–185.
19.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4. Washington, APA, 1994.
20.
McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM: Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA work group under the auspices of department of health and human services task force an Alzheimer’s disease. Neurology 1984;34:939–944.
21.
The Lund and Manchester Groups: Clinical and neuropathological criteria for frontotemporal dementia. J Neurol Neurosurg Psychiatry 1994;57:416–418.
22.
Folstein MF, Folstein SE, McHugh PR: Mini-Mental State. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
23.
Reisberg B, Ferris SH, deLeon MJ, Crook T: The global deterioration scale for assessment of primary degenerative dementia. Am J Psychol 1982;139:1136–1139.
24.
Schnitzlein HN, Murtagh FR: Imaging Anatomy of the Head and Spine. A Photographic Color Atlas of MRI, CT, Gross, and Microscopic Anatomy in Axial, Coronal, and Sagittal Planes, ed 2. Baltimore, Urban and Schwarzenberg, 1990.
25.
Foster NL, Chase TN, Fedio P, Patronas NJ, Brooks RA, DiChiro G: Alzheimer’s disease: Focal cortical changes shown by positron emission tomography. Neurology 1983;33:961–965.
26.
Haxby JV, Grady CL, Koss E, Horwitz B, Schapiro M, Friedland RP, Rapoport SI: Heterogeneous anterior-posterior metabolic patterns in dementia of the Alzheimer type. Neurology 1988;38:1853–1863.
27.
Haxby JV, Grady CL, Duara R, Schlageter N, Berg G, Rapoport SI: Neocortical metabolic abnormalites precede nonmemory cognitive defects in early Alzheimer’s type dementia. Arch Neurol 1986;43:882–885.
28.
Minoshima S, Giordan B, Berent S, Frey KA, Foster NL, Kuhl DE: Metabolic reduction in the posterior cingulate cortex in very early Alzheimer’s disease. Ann Neurol 1997;42:85–94.
29.
Kamo H, McGeer P, Harrop R, McGeer E, Calne DB, Martin WRW, Pate BD: PET and histopathology in Pick’s disease. Neurology 1987;37:439–445.
30.
Lieberman AP, Trojanowski JQ, Lee VM, Balin BJ, Ding XS, Greenberg J, Morrison D, Reivich M, Grossman M: Cognitive, neuroimaging and pathological studies in a patient with Pick’s disease. Ann Neurol 1998;43:259–265.
31.
Garraux G, Salmon E, Degueldre C, Lemaire C, Franck G: Medial temporal lobe metabolic impairment in dementia associated with motor neuron disease. J Neurol Sci 1999;168:145–150.
32.
Duara R, Barker W, Loewenstein D, Pascal S, Bowen B: Sensitivity and specificity of positron emission tomography and magnetic resonance imaging studies in Alzheimer’s disease and multi-infarct dementia. Eur Neurol 1989;29 (suppl 3):9–15.
33.
Imamura T, Ishii K, Sasaki M, Kitagaki H, Yamaji S, Hirono N, Shimomura T, Hashimoto M, Tanimukai S, Mori E: Regional cerebral glucose metabolism in dementia with Lewy bodies and Alzheimer’s disease: A comparative study using positron emission tomography. Neurosci Lett 1997;235:49–52.
34.
Powers WJ, Perlmutter JS, Videen TO, Herscovitch P, Griffeth LK, Royal HD, Siegel BA, Morris JC, Berg L: Blinded clinical evaluation of positron emission tomography for diagnosis of probable Alzheimer’s disease. Neurology 1992;42:765–770.
35.
Pasquier F, Petit H: Frontotemporal dementia: Its rediscovery. Eur Neurol 1997;38:1–6.
36.
Albin RL, Minoshima S, D’Amato CJ, Frey KA, Kuhl DA, Sima AAF: Fluorodeoxyglucose positron emission tomography in diffuse Lewy body disease. Neurology 1996;47:462–466.
37.
Tanaka M, Kondo S, Hirai S, Sun X, Yamagishi T, Okamoto K: Cerebral blood flow and oxygen metabolism in progressive dementia with amyotrophic lateral sclerosis. J Neurol Sci 1993;120:22–28.
38.
Akiyama H, Harrop R, McGeer PL, Peppard R, McGeer EG: Crossed cerebellar and uncrossed basal ganglia and thalamic diaschisis in Alzheimer’s disease. Neurology 1989;39:541–548.
39.
Ishii K, Sasaki M, Kitagaki H, Yamaju S, Sakamoto S, Matsuda K, Mori E: Reduction of cerebellar glucose metabolism in advanced Alzheimer’s disease. J Nucl Med 1997;38:925–928.
40.
Lammertsma A, Sawle GV, Frackowiak RSJ: Ageing and brain: Clinical perspectives for PET. Techn Health Care 1993;1:11–17.
41.
Mielke R, Kessler J, Szelies B, Herholz K, Wienhard K, Heiss WD: Normal and pathological aging-findings of positron emission tomography. J Neural Transm 1998;105:821–837.
42.
Imran MB, Kawashima R, Awata S, Kazunori S, Kinomura S, Ono S, Sato M, Fukuda H: Tc-99m HMPAO SPECT in the evaluation of Alzheimer’s disease correlation between neuropsychiatric evaluation and CBF images. J Neurol Neurosurg Psychiatry 1997;66:228–232.
43.
Braak H, Braak E: Neuropathological staging of Alzheimer-related changes. Acta Neuropathol 1991;82:239–259.
44.
Frisoni GB, Beltramello A, Geroldi C, Weiss C, Bianchetti A, Trabucchi M: Brain atrophy in frontotemporal dementia. J Neurol Neurosurg Psychiatry 1996;61:157–165.
45.
Kesslak JP, Nalcioglu O, Cotman CW: Quantification of magnetic resonance scans for hippocampal and parahippocampal atrophy in Alzheimer’s disease. Neurology 1991;41:51–54.
46.
Jobst KA, Smith AD, Szatmari M, Molyneux A, Esiri ME, King E, Smith A, Jaskowski A, Mc Donald B, Wald N: Detection in life of confirmed Alzheimer’s disease using a simple measurement of medial temporal lobe atrophy by computed tomography. Lancet 1992;340:1179–1183.
47.
Ishii K, Sasaki M, Yamaji S, Sakamoto S, Kitagaki H, Mori E: Paradoxical hippocampus perfusion in mild-to-moderate Alzheimer’s disease. J Nucl Med 1998;39:293–298.
48.
Ishii K, Sasaki M, Yamaji S, Sakamoto S, Kitagaki H, Mori E: Relatively preserved hippocampal glucose metabolism in mild Alzheimer’s disease. Dement Geriatr Cogn Disord 1998;9:317–322.
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