Rombouts S A R B, van Swieten J C, Pijnenburg Y A L, Goekoop R, Barkhof F, Scheltens P
Department of Neurology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
Neurology. 2003 Jun 24;60(12):1904-8. doi: 10.1212/01.wnl.0000069462.11741.ec.
To compare frontal cortex activation in patients with early frontotemporal dementia (FTD) with that in patients with early AD.
Seven patients with FTD and seven patients with AD were studied (Clinical Dementia Rating: four patients with FTD 0.5, three patients with FTD 1, all patients with AD 1; mean Mini-Mental State Examination score: FTD 28.0 +/- 2.1, AD 23.1 +/- 2.7). Cerebral atrophy on MRI was mild, with no differences between FTD and AD. A parametric working memory task was applied to assess frontal activation as a function of working memory load.
The activated working memory network in FTD and AD included frontal and parietal lobe and thalamus. In frontal and parietal cortex, brain activation was significantly decreased in FTD. Frontal regions in patients with FTD showed less linear activation increase with working memory load than in AD. Possibly as a compensation mechanism, the cerebellum showed a stronger increasing response in FTD.
These data on regional functional loss in the frontal cortex in early FTD suggest that fMRI can identify FTD when results on structural MRI are normal.
比较早期额颞叶痴呆（FTD）患者与早期阿尔茨海默病（AD）患者额叶皮质的激活情况。
对7例FTD患者和7例AD患者进行研究（临床痴呆评定量表：4例FTD患者评分为0.5，3例FTD患者评分为1，所有AD患者评分为1；简易精神状态检查表平均得分：FTD为28.0±2.1，AD为23.1±2.7）。MRI显示脑萎缩程度较轻，FTD和AD之间无差异。应用参数化工作记忆任务来评估额叶激活情况，将其作为工作记忆负荷的函数。
FTD和AD中被激活的工作记忆网络包括额叶、顶叶和丘脑。在额叶和顶叶皮质，FTD患者的脑激活显著降低。与AD患者相比，FTD患者额叶区域随工作记忆负荷的线性激活增加较少。可能作为一种补偿机制，小脑在FTD中表现出更强的增强反应。
这些关于早期FTD患者额叶皮质区域功能丧失的数据表明，当结构MRI结果正常时，功能磁共振成像（fMRI）能够识别FTD。
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