Differentiation of frontotemporal dementia from dementia with Lewy bodies using FP-CIT SPECT
Journal of Neurology, Neurosurgery & Psychiatry, 08/21/2012
Clinical Article
Morgan S et al. – The study highlights to clinicians that a positive (abnormal) [123I]FP–CIT SPECT scan, even in a patient with an extrapyramidal motor sign (EPMS), does not exclude the diagnosis of frontotemporal dementia (FTD) and emphasises the importance of a comprehensive clinical evaluation and a detailed cognitive assessment.
Methods- The authors compared the striatal dopamine transporter (DAT) binding in FTD (n=12), DLB (n=10) and AD (n=9) by visually rating the caudate and putamen on [123I]FP-CIT SPECT scans.
- The majority (9/10) of DLB cases had an abnormal scan and a significant reduction of uptake of DAT binding in the putamen and the caudate.
- A third (4/12) of the FTD cases also had an abnormal scan and a significant reduction in uptake in the putamen and the caudate.
- In contrast, only one out of nine AD cases had an abnormal scan.
- Significant differences were found when comparisons were made between the groups for visual analysis of the entire scan (p=0.001) and the four regions of interest (p=0.001- 0.013).
- In contrast to the AD group (specificity of scan 89%), the specificity of [123I]FP-CIT SPECT scans was reduced in the FTD group to 67%.
- Three quarters of the study population had at least one extrapyramidal motor sign (EPMS), with bradykinesia being the most common EPMS in both FTD (83%) and DLB (70%).
