Gregory C A, Serra-Mestres J, Hodges J R
Fulbourn Hospital, Cambridge, England.
Neuropsychiatry Neuropsychol Behav Neurol. 1999 Apr;12(2):128-35.
To examine the role of structural (magnetic resonance imaging [MRI]) and functional (single photon emission computed tomography [SPECT]) imaging and neuropsychologic evaluation in the early diagnosis of frontal variant frontotemporal dementia (fvFTD).
Current criteria for FTD stress the need for neuropsychologic and functional neuroimaging abnormalities, yet caregivers report lengthy histories of behavioral change. It is not known when, in the course of the disease, these investigations become abnormal, because few longitudinal studies have been reported.
Longitudinal study of two patients with serial neuropsychologic evaluation and MRI and HMPAO-SPECT scanning.
Both patients, men aged 49 and 50, had major changes in personality, behavior, and social conduct that progressed over 5 to 6 years in a way that conformed to the clinical picture of fvFTD. There was remarkably little abnormality on neuropsychologic testing, and MRI and HMPAO-SPECT findings initially were normal. Over time, however, abnormalities on SPECT, frontal atrophy on MRI, or a neuropsychologic profile more typical of fvFTD developed in both patients.
Standard neuropsychologic tests and conventional brain imaging techniques (MRI and SPECT) may not be sensitive to the early changes in fvFTD that occur in the ventromedial frontal cortex, and better methods of accurate early detection are required. These findings are relevant to the diagnostic criteria for FTD.
探讨结构成像（磁共振成像[MRI]）、功能成像（单光子发射计算机断层扫描[SPECT]）及神经心理学评估在额颞叶痴呆额叶变异型（fvFTD）早期诊断中的作用。
目前FTD的诊断标准强调神经心理学及功能神经影像学异常的必要性，但照料者报告行为改变的病史较长。由于鲜有纵向研究报道，尚不清楚在疾病进程中这些检查何时会出现异常。
对两名患者进行纵向研究，进行系列神经心理学评估、MRI及HMPAO-SPECT扫描。
两名患者均为49岁和50岁男性，其人格、行为及社交行为发生了重大变化，在5至6年的时间里逐渐发展，符合fvFTD的临床表现。神经心理学测试异常极少，MRI及HMPAO-SPECT检查结果最初均正常。然而，随着时间推移，两名患者均出现了SPECT异常、MRI额叶萎缩或更典型的fvFTD神经心理学特征。
标准神经心理学测试及传统脑成像技术（MRI和SPECT）可能对fvFTD发生于额叶腹内侧皮质的早期变化不敏感，需要更好的早期准确检测方法。这些发现与FTD的诊断标准相关。
