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This version was published on May 1, 2008
American Journal of Alzheimer's Disease and Other Dementias®, Vol. 23, No. 2, 184-191 (2008)
DOI: 10.1177/1533317507312621

Correlative Studies of Structural and Functional Imaging in Primary Progressive Aphasia

P.K. Panegyres, PhD

Neurosciences Unit, Health Department of Western Australia, Mt Claremont, Neurodegenerative Disorders Research, Subiaco Western Australia, Australia, macfarlane4{at}optusnet.co.au

M. McCarthy, MBBS

Department of Nuclear Medicine, Royal Perth Hospital, Perth, WA PET/Cyclotron Service, Sir Charles Gairdner Hospital, Shenton Park, Nuclear Medicine Service, Perth Radiological Clinic, Subiaco

A. Campbell, PhD

Department of Nuclear Medicine, Royal Perth Hospital, Perth

N. Lenzo, MBBS

Department of Nuclear Medicine, Royal Perth Hospital, Perth, WA PET/Cyclotron Service, Sir Charles Gairdner Hospital, Shenton Park

M. Fallon, MBBS

Nuclear Medicine Service, Perth Radiological Clinic, Subiaco

J. Thompson, BSc

Department of Nuclear Medicine, Royal Perth Hospital, Perth

Rationale: To compare and contrast structural and functional imaging in primary progressive aphasia (PPA). Methods: A cohort of 8 patients diagnosed with PPA presenting with nonfluency were prospectively evaluated. All patients had structural imaging in the form of MRI and in 1 patient CAT scanning on account of a cardiac pacemaker. All patients had single-photon emission computed tomography (SPECT) and positron emission tomography (PET) imaging. Results: SPECT and PET imaging had 100% correlation. Anatomical imaging was abnormal in only 6 of the 8 patients. Wernicke's area showed greater peak Z score reduction and extent of area affected than Broca's area (McNemar paired test: P = .008 for Z score reduction; P = .0003 for extent). PET scanning revealed significant involvement of the anterior cingulum. Conclusion: Functional imaging in PPA: (a) identified more patients correctly than anatomic imaging highlighting the importance of SPECT and PET in the diagnosis; and (b) demonstrated the heterogeneous involvement of disordered linguistic networks in PPA suggesting its syndromic nature.

Key Words: primary progressive aphasia • imaging


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