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The Role of Brain Single Photon Emission Computed Tomography in the Diagnosis of Primary Progressive Aphasia

The Role of Brain Single Photon Emission Computed Tomography in the Diagnosis of Primary... Abstract • We present two cases of primary progressive aphasia studied with neuropsychologic measures, computed tomography or magnetic resonance imaging, and single-photon emission computed tomography with technetium Tc 99m-labeled hexamethyl-propyleneamine oxime. Clinical and neuropsychologic observations revealed a marked, progressive loss of language functions over time with relative preservation of nonlanguage cognitive functions in both patients. The brain single-photon emission computed tomographic scan revealed marked left frontal and minimal left temporal and parietal hypoperfusion in case 1 and marked left posterior frontal and minimal left temporal hypoperfusion in case 2. The value of brain single-photon emission computed tomography in distinguishing primary progressive aphasia from Alzheimer's disease is described. References 1. Mesulam MM. Slowly progressive aphasia without generalized dementia . Ann Neurol . 1982;11:592-598.Crossref 2. Heath PD, Kennedy P, Napur N. Slowly progressive aphasia without generalized dementia . Ann Neurol . 1983;13:687-688.Crossref 3. Chawluk JB, Mesulam MM, Hurtig H, et al. Slowly progressive aphasia without generalized dementia: studies with positron emission tomography . Ann Neurol . 1986;19:68-74.Crossref 4. Kirshner HS, Tanridag O, Thurman L, Whetsell WO Jr. Progressive aphasia without dementia: two cases with focal spongiform degeneration . Ann Neurol . 1987;22:527-532.Crossref 5. Mesulam MM. Primary progressive aphasia: differentiation from Alzheimer's disease . Ann Neurol . 1987;22:533-534.Crossref 6. Foster NL, Chase TN. Diffuse involvement in progressive aphasia . Ann Neurol . 1983;13:224-225.Crossref 7. Gordon B, Selnes O. Progressive aphasia 'without dementia': evidence of more widespread involvement . Neurology . 1984;34( (suppl 1) ):102.Crossref 8. Kirshner H, Webb WG, Kelley MP, Wells CE. Language disturbance: an initial symptom of cortical degenerations and dementia . Arch Neurol . 1984;41:491-496.Crossref 9. Poeck K, Luzzatti C. Slowly progressive aphasia in three patients: the problem of accompanying neuropsychological deficit . Brain . 1988;111:151-168.Crossref 10. Weintraub S, Rubin NP, Mesulam MM. Primary progressive aphasia: longitudinal course, neuropsychological profile, and language features . Arch Neurol . 1990;47:1329-1335.Crossref 11. Kempler D, Metter EJ, Riege WH, Jackson CA, Benson DF, Hanson WR. Slowly progressive aphasia with language, memory, CT and PET data . J Neurol Neurosurg Psychiatry . 1990;53:987-993.Crossref 12. Foster NL, Chase TN, Mansi L, et al. Cortical abnormalities in Alzheimer's disease . Ann Neurol . 1984;16:649-654.Crossref 13. Friedland RP, Brun A, Budinger TF. Pathological and positron emission tomographic correlations in Alzheimer's disease . Lancet . 1985;1:228.Crossref 14. Friedland RP, Jagust WJ, Huesman RH, et al. Regional cerebral glucose transport and utilization in Alzheimer's disease . Neurology . 1989;39:1427-1438.Crossref 15. Galasko D, Thal LJ, Gierz M, Rothland J, Butters N. Frontal lobe impairment in patients with progressive aphasia . Neurology . 1990;40( (suppl 1) ):199. 16. Snowden JS, Neary D, Mann DMA. Progressive aphasia due to lobar atrophy . Neurobiol Aging . 1990;11:258-259. 17. Kushner M. MRI and 123I-iodoamphetamine SPECT imaging of a patient with slowly progressive aphasia . Adv Funct Neuroimaging . 1989;17-19. 18. Goulding DJ, Northern B, SnowdenJS, Macdermott N, Neary D. Progressive aphasia with right sided extrapyramidal signs: another manifestation of localized cerebral atrophy . J Neurol Neurosurg Psychiatry . 1989;52:128-129.Crossref 19. Caine ED, Bamford KA, Schiffer RB, Shoulson I, Levy S. A controlled neuropsychological comparison of Huntington's disease and multiple sclerosis . Arch Neurol . 1986;43:249-254.Crossref 20. Russell EW. A multiple scoring method for the assessment of complex memory functions . J Consult Clin Psychol . 1975;43:800-809.Crossref 21. Russell EW. Renorming Russell's version of the Wechsler Memory Scale . J Clin Exp Neuropsychol . 1988;10:235-249.Crossref 22. Sapin LR, Anderson FH, Pulaski PD. Progressive aphasia without dementia: further documentation . Ann Neurol . 1989;25:411-413.Crossref 23. Berger ML, Porch BE. A longitudinal study of primary progressive aphasia . Neurology . 1990;40( (suppl 1) ):198. 24. Feher EP, Doody RS, Whitehead J, Pirozzolo FJ. Progressive nonfluent aphasia . Neurology . 1990;40( (suppl 1) ):199. 25. Appell J, Kertesz A, Fisman M. A study of language functioning in Alzheimer patients . Brain Lang . 1982;17:73-91.Crossref 26. Cummings JL, Benson DF, Hill MA, Read S. Aphasia in dementia of the Alzheimer type . Neurology . 1985;35:394-397.Crossref 27. Murdoch BE, Chenery HJ. Language disorders in dementia of the Alzheimer type . Brain Lang . 1987;31:122-137.Crossref 28. Kobayashi K, Kurachi M, Gyoubu T, et al. Progressive dysphasic dementia with localized cerebral atrophy: report of an autopsy . Clin Neuropathol . 1990;9:254-261. 29. Green J, Morris JC, Sandson J, McKeel DW, Miller JW. Progressive aphasia: a precursor of global dementia? Neurology . 1990;40:423-429.Crossref 30. Case records of the Massachusetts General Hospital: weekly clinicopathological exercises . N Engl J Med . 1986;314:1101-1111.Crossref 31. Graff-Radford NR, Damasio AR, Hyman BT, et al. Progressive aphasia in a patient with Pick's disease: a neuropsychological, radiologic and anatomic study . Neurology . 1990;40:620-626.Crossref 32. Johnson KA, Mueller ST, Walshe TM, English RJ, Holman BL. Cerebral perfusion imaging in Alzheimer's disease: use of single photon emission computed tomography and iofetamine hydrochloride I123 . Arch Neurol . 1987;44:165-168.Crossref 33. Neary D, Snowden JS, Shields RA, et al. Single photon emission tomography using 99mTc-HM-PAO in the investigation of dementia . J Neurol Neurosurg Psychiatry . 1987;50:1101-1109.Crossref 34. Burns A, Philpot MP, Costa DC, Ell PJ, Levy R. The investigation of Alzheimer's disease with single photon emission tomography . J Neurol Neurosurg Psychiatry . 1989;52:248-253.Crossref 35. Hellman RS, Tikofsky RS, Collier BD, et al. Alzheimer disease: quantitative analysis of I 123-iodoamphetamine SPECT brain imaging . Radiology . 1989;172:183-188.Crossref 36. DeKosky ST, Shih WJ, Schmitt FA, Coupal J, Kirkpatrick C. Assessing utility of single photon emission computed tomography (SPECT) scan in Alzheimer disease: correlation with cognitive severity . Alzheimer Dis Assoc Disord . 1990;4:14-23.Crossref 37. Johnson KA, Holman BL, Rosen TJ, Nagel JS, English RJ, Growdon JH. Iofectamine I123 single photon emission computed tomography is accurate in the diagnosis of Alzheimer's disease . Arch Intern Med . 1990;150:752-756.Crossref 38. Montaldi D, Brooks DN, McColl JH, et al. Measurements of regional cerebral blood flow and cognitive performance in Alzheimer's disease . J Neurol Neurosurg Psychiatry . 1990;53:33-38.Crossref 39. Caselli RJ. The syndrome of focal cerebral degeneration: clinical, anatomic, and single photon emission computed tomography (SPECT) correlations . Neurology . 1990;40( (suppl 1) ):175.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

The Role of Brain Single Photon Emission Computed Tomography in the Diagnosis of Primary Progressive Aphasia

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1991.00530240061021
Publisher site
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Abstract

Abstract • We present two cases of primary progressive aphasia studied with neuropsychologic measures, computed tomography or magnetic resonance imaging, and single-photon emission computed tomography with technetium Tc 99m-labeled hexamethyl-propyleneamine oxime. Clinical and neuropsychologic observations revealed a marked, progressive loss of language functions over time with relative preservation of nonlanguage cognitive functions in both patients. The brain single-photon emission computed tomographic scan revealed marked left frontal and minimal left temporal and parietal hypoperfusion in case 1 and marked left posterior frontal and minimal left temporal hypoperfusion in case 2. The value of brain single-photon emission computed tomography in distinguishing primary progressive aphasia from Alzheimer's disease is described. References 1. Mesulam MM. Slowly progressive aphasia without generalized dementia . Ann Neurol . 1982;11:592-598.Crossref 2. Heath PD, Kennedy P, Napur N. Slowly progressive aphasia without generalized dementia . Ann Neurol . 1983;13:687-688.Crossref 3. Chawluk JB, Mesulam MM, Hurtig H, et al. Slowly progressive aphasia without generalized dementia: studies with positron emission tomography . Ann Neurol . 1986;19:68-74.Crossref 4. Kirshner HS, Tanridag O, Thurman L, Whetsell WO Jr. Progressive aphasia without dementia: two cases with focal spongiform degeneration . Ann Neurol . 1987;22:527-532.Crossref 5. Mesulam MM. Primary progressive aphasia: differentiation from Alzheimer's disease . Ann Neurol . 1987;22:533-534.Crossref 6. Foster NL, Chase TN. Diffuse involvement in progressive aphasia . Ann Neurol . 1983;13:224-225.Crossref 7. Gordon B, Selnes O. Progressive aphasia 'without dementia': evidence of more widespread involvement . Neurology . 1984;34( (suppl 1) ):102.Crossref 8. Kirshner H, Webb WG, Kelley MP, Wells CE. Language disturbance: an initial symptom of cortical degenerations and dementia . Arch Neurol . 1984;41:491-496.Crossref 9. Poeck K, Luzzatti C. Slowly progressive aphasia in three patients: the problem of accompanying neuropsychological deficit . Brain . 1988;111:151-168.Crossref 10. Weintraub S, Rubin NP, Mesulam MM. Primary progressive aphasia: longitudinal course, neuropsychological profile, and language features . Arch Neurol . 1990;47:1329-1335.Crossref 11. Kempler D, Metter EJ, Riege WH, Jackson CA, Benson DF, Hanson WR. Slowly progressive aphasia with language, memory, CT and PET data . J Neurol Neurosurg Psychiatry . 1990;53:987-993.Crossref 12. Foster NL, Chase TN, Mansi L, et al. Cortical abnormalities in Alzheimer's disease . Ann Neurol . 1984;16:649-654.Crossref 13. Friedland RP, Brun A, Budinger TF. Pathological and positron emission tomographic correlations in Alzheimer's disease . Lancet . 1985;1:228.Crossref 14. Friedland RP, Jagust WJ, Huesman RH, et al. Regional cerebral glucose transport and utilization in Alzheimer's disease . Neurology . 1989;39:1427-1438.Crossref 15. Galasko D, Thal LJ, Gierz M, Rothland J, Butters N. Frontal lobe impairment in patients with progressive aphasia . Neurology . 1990;40( (suppl 1) ):199. 16. Snowden JS, Neary D, Mann DMA. Progressive aphasia due to lobar atrophy . Neurobiol Aging . 1990;11:258-259. 17. Kushner M. MRI and 123I-iodoamphetamine SPECT imaging of a patient with slowly progressive aphasia . Adv Funct Neuroimaging . 1989;17-19. 18. Goulding DJ, Northern B, SnowdenJS, Macdermott N, Neary D. Progressive aphasia with right sided extrapyramidal signs: another manifestation of localized cerebral atrophy . J Neurol Neurosurg Psychiatry . 1989;52:128-129.Crossref 19. Caine ED, Bamford KA, Schiffer RB, Shoulson I, Levy S. A controlled neuropsychological comparison of Huntington's disease and multiple sclerosis . Arch Neurol . 1986;43:249-254.Crossref 20. Russell EW. A multiple scoring method for the assessment of complex memory functions . J Consult Clin Psychol . 1975;43:800-809.Crossref 21. Russell EW. Renorming Russell's version of the Wechsler Memory Scale . J Clin Exp Neuropsychol . 1988;10:235-249.Crossref 22. Sapin LR, Anderson FH, Pulaski PD. Progressive aphasia without dementia: further documentation . Ann Neurol . 1989;25:411-413.Crossref 23. Berger ML, Porch BE. A longitudinal study of primary progressive aphasia . Neurology . 1990;40( (suppl 1) ):198. 24. Feher EP, Doody RS, Whitehead J, Pirozzolo FJ. Progressive nonfluent aphasia . Neurology . 1990;40( (suppl 1) ):199. 25. Appell J, Kertesz A, Fisman M. A study of language functioning in Alzheimer patients . Brain Lang . 1982;17:73-91.Crossref 26. Cummings JL, Benson DF, Hill MA, Read S. Aphasia in dementia of the Alzheimer type . Neurology . 1985;35:394-397.Crossref 27. Murdoch BE, Chenery HJ. Language disorders in dementia of the Alzheimer type . Brain Lang . 1987;31:122-137.Crossref 28. Kobayashi K, Kurachi M, Gyoubu T, et al. Progressive dysphasic dementia with localized cerebral atrophy: report of an autopsy . Clin Neuropathol . 1990;9:254-261. 29. Green J, Morris JC, Sandson J, McKeel DW, Miller JW. Progressive aphasia: a precursor of global dementia? Neurology . 1990;40:423-429.Crossref 30. Case records of the Massachusetts General Hospital: weekly clinicopathological exercises . N Engl J Med . 1986;314:1101-1111.Crossref 31. Graff-Radford NR, Damasio AR, Hyman BT, et al. Progressive aphasia in a patient with Pick's disease: a neuropsychological, radiologic and anatomic study . Neurology . 1990;40:620-626.Crossref 32. Johnson KA, Mueller ST, Walshe TM, English RJ, Holman BL. Cerebral perfusion imaging in Alzheimer's disease: use of single photon emission computed tomography and iofetamine hydrochloride I123 . Arch Neurol . 1987;44:165-168.Crossref 33. Neary D, Snowden JS, Shields RA, et al. Single photon emission tomography using 99mTc-HM-PAO in the investigation of dementia . J Neurol Neurosurg Psychiatry . 1987;50:1101-1109.Crossref 34. Burns A, Philpot MP, Costa DC, Ell PJ, Levy R. The investigation of Alzheimer's disease with single photon emission tomography . J Neurol Neurosurg Psychiatry . 1989;52:248-253.Crossref 35. Hellman RS, Tikofsky RS, Collier BD, et al. Alzheimer disease: quantitative analysis of I 123-iodoamphetamine SPECT brain imaging . Radiology . 1989;172:183-188.Crossref 36. DeKosky ST, Shih WJ, Schmitt FA, Coupal J, Kirkpatrick C. Assessing utility of single photon emission computed tomography (SPECT) scan in Alzheimer disease: correlation with cognitive severity . Alzheimer Dis Assoc Disord . 1990;4:14-23.Crossref 37. Johnson KA, Holman BL, Rosen TJ, Nagel JS, English RJ, Growdon JH. Iofectamine I123 single photon emission computed tomography is accurate in the diagnosis of Alzheimer's disease . Arch Intern Med . 1990;150:752-756.Crossref 38. Montaldi D, Brooks DN, McColl JH, et al. Measurements of regional cerebral blood flow and cognitive performance in Alzheimer's disease . J Neurol Neurosurg Psychiatry . 1990;53:33-38.Crossref 39. Caselli RJ. The syndrome of focal cerebral degeneration: clinical, anatomic, and single photon emission computed tomography (SPECT) correlations . Neurology . 1990;40( (suppl 1) ):175.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Dec 1, 1991

References