FDG PET and MRI in Logopenic Primary Progressive Aphasia versus Dementia of the Alzheimer's Type

Ajay Madhavan, Jennifer Lynn Whitwell, Stephen D. Weigand, Joseph R. Duffy, Edythe A. Strand, Mary Margaret Machulda, Nirubol Tosakulwong, Matthew L. Senjem, Jeffrey L. Gunter, Val Lowe, Ronald Carl Petersen, Clifford R Jr. Jack, Keith Anthony Josephs

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Abstract

Objectives:The logopenic variant of primary progressive aphasia is an atypical clinical variant of Alzheimer's disease which is typically characterized by left temporoparietal atrophy on magnetic resonance imaging and hypometabolism on F-18 fluorodeoxyglucose positron emission tomography. We aimed to characterize and compare patterns of atrophy and hypometabolism in logopenic primary progressive aphasia, and determine which brain regions and imaging modality best differentiates logopenic primary progressive aphasia from typical dementia of the Alzheimer's type.Methods:A total of 27 logopenic primary progressive aphasia subjects underwent fluorodeoxyglucose positron emission tomography and volumetric magnetic resonance imaging. These subjects were matched to 27 controls and 27 subjects with dementia of the Alzheimer's type. Patterns of atrophy and hypometabolism were assessed at the voxel and region-level using Statistical Parametric Mapping. Penalized logistic regression analysis was used to determine what combinations of regions best discriminate between groups.Results:Atrophy and hypometabolism was observed in lateral temporoparietal and medial parietal lobes, left greater than right, and left frontal lobe in the logopenic group. The logopenic group showed greater left inferior, middle and superior lateral temporal atrophy (inferior p = 0.02; middle p = 0.007, superior p = 0.002) and hypometabolism (inferior p = 0.006, middle p = 0.002, superior p = 0.001), and less right medial temporal atrophy (p = 0.02) and hypometabolism (p<0.001), and right posterior cingulate hypometabolism (p<0.001) than dementia of the Alzheimer's type. An age-adjusted penalized logistic model incorporating atrophy and hypometabolism achieved excellent discrimination (area under the receiver operator characteristic curve = 0.89) between logopenic and dementia of the Alzheimer's type subjects, with optimal discrimination achieved using right medial temporal and posterior cingulate hypometabolism, left inferior, middle and superior temporal hypometabolism, and left superior temporal volume.Conclusions:Patterns of atrophy and hypometabolism both differ between logopenic primary progressive aphasia and dementia of the Alzheimer's type and both modalities provide excellent discrimination between groups.

Original languageEnglish (US)
Article numbere62471
JournalPLoS One
Volume8
Issue number4
DOIs
StatePublished - Apr 23 2013

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Primary Progressive Aphasia
dementia
atrophy
Magnetic resonance imaging
Atrophy
Alzheimer Disease
Positron emission tomography
Magnetic resonance
Imaging techniques
Logistics
Fluorodeoxyglucose F18
positron-emission tomography
Regression analysis
Gyrus Cinguli
Brain
magnetic resonance imaging
Positron-Emission Tomography
Logistic Models
Magnetic Resonance Imaging
Parietal Lobe

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

FDG PET and MRI in Logopenic Primary Progressive Aphasia versus Dementia of the Alzheimer's Type. / Madhavan, Ajay; Whitwell, Jennifer Lynn; Weigand, Stephen D.; Duffy, Joseph R.; Strand, Edythe A.; Machulda, Mary Margaret; Tosakulwong, Nirubol; Senjem, Matthew L.; Gunter, Jeffrey L.; Lowe, Val; Petersen, Ronald Carl; Jack, Clifford R Jr.; Josephs, Keith Anthony.

In: PLoS One, Vol. 8, No. 4, e62471, 23.04.2013.

Research output: Contribution to journalArticle

Madhavan, Ajay ; Whitwell, Jennifer Lynn ; Weigand, Stephen D. ; Duffy, Joseph R. ; Strand, Edythe A. ; Machulda, Mary Margaret ; Tosakulwong, Nirubol ; Senjem, Matthew L. ; Gunter, Jeffrey L. ; Lowe, Val ; Petersen, Ronald Carl ; Jack, Clifford R Jr. ; Josephs, Keith Anthony. / FDG PET and MRI in Logopenic Primary Progressive Aphasia versus Dementia of the Alzheimer's Type. In: PLoS One. 2013 ; Vol. 8, No. 4.
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AU - Whitwell, Jennifer Lynn

AU - Weigand, Stephen D.

AU - Duffy, Joseph R.

AU - Strand, Edythe A.

AU - Machulda, Mary Margaret

AU - Tosakulwong, Nirubol

AU - Senjem, Matthew L.

AU - Gunter, Jeffrey L.

AU - Lowe, Val

AU - Petersen, Ronald Carl

AU - Jack, Clifford R Jr.

AU - Josephs, Keith Anthony

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N2 - Objectives:The logopenic variant of primary progressive aphasia is an atypical clinical variant of Alzheimer's disease which is typically characterized by left temporoparietal atrophy on magnetic resonance imaging and hypometabolism on F-18 fluorodeoxyglucose positron emission tomography. We aimed to characterize and compare patterns of atrophy and hypometabolism in logopenic primary progressive aphasia, and determine which brain regions and imaging modality best differentiates logopenic primary progressive aphasia from typical dementia of the Alzheimer's type.Methods:A total of 27 logopenic primary progressive aphasia subjects underwent fluorodeoxyglucose positron emission tomography and volumetric magnetic resonance imaging. These subjects were matched to 27 controls and 27 subjects with dementia of the Alzheimer's type. Patterns of atrophy and hypometabolism were assessed at the voxel and region-level using Statistical Parametric Mapping. Penalized logistic regression analysis was used to determine what combinations of regions best discriminate between groups.Results:Atrophy and hypometabolism was observed in lateral temporoparietal and medial parietal lobes, left greater than right, and left frontal lobe in the logopenic group. The logopenic group showed greater left inferior, middle and superior lateral temporal atrophy (inferior p = 0.02; middle p = 0.007, superior p = 0.002) and hypometabolism (inferior p = 0.006, middle p = 0.002, superior p = 0.001), and less right medial temporal atrophy (p = 0.02) and hypometabolism (p<0.001), and right posterior cingulate hypometabolism (p<0.001) than dementia of the Alzheimer's type. An age-adjusted penalized logistic model incorporating atrophy and hypometabolism achieved excellent discrimination (area under the receiver operator characteristic curve = 0.89) between logopenic and dementia of the Alzheimer's type subjects, with optimal discrimination achieved using right medial temporal and posterior cingulate hypometabolism, left inferior, middle and superior temporal hypometabolism, and left superior temporal volume.Conclusions:Patterns of atrophy and hypometabolism both differ between logopenic primary progressive aphasia and dementia of the Alzheimer's type and both modalities provide excellent discrimination between groups.

AB - Objectives:The logopenic variant of primary progressive aphasia is an atypical clinical variant of Alzheimer's disease which is typically characterized by left temporoparietal atrophy on magnetic resonance imaging and hypometabolism on F-18 fluorodeoxyglucose positron emission tomography. We aimed to characterize and compare patterns of atrophy and hypometabolism in logopenic primary progressive aphasia, and determine which brain regions and imaging modality best differentiates logopenic primary progressive aphasia from typical dementia of the Alzheimer's type.Methods:A total of 27 logopenic primary progressive aphasia subjects underwent fluorodeoxyglucose positron emission tomography and volumetric magnetic resonance imaging. These subjects were matched to 27 controls and 27 subjects with dementia of the Alzheimer's type. Patterns of atrophy and hypometabolism were assessed at the voxel and region-level using Statistical Parametric Mapping. Penalized logistic regression analysis was used to determine what combinations of regions best discriminate between groups.Results:Atrophy and hypometabolism was observed in lateral temporoparietal and medial parietal lobes, left greater than right, and left frontal lobe in the logopenic group. The logopenic group showed greater left inferior, middle and superior lateral temporal atrophy (inferior p = 0.02; middle p = 0.007, superior p = 0.002) and hypometabolism (inferior p = 0.006, middle p = 0.002, superior p = 0.001), and less right medial temporal atrophy (p = 0.02) and hypometabolism (p<0.001), and right posterior cingulate hypometabolism (p<0.001) than dementia of the Alzheimer's type. An age-adjusted penalized logistic model incorporating atrophy and hypometabolism achieved excellent discrimination (area under the receiver operator characteristic curve = 0.89) between logopenic and dementia of the Alzheimer's type subjects, with optimal discrimination achieved using right medial temporal and posterior cingulate hypometabolism, left inferior, middle and superior temporal hypometabolism, and left superior temporal volume.Conclusions:Patterns of atrophy and hypometabolism both differ between logopenic primary progressive aphasia and dementia of the Alzheimer's type and both modalities provide excellent discrimination between groups.

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